Evolution of adjuvant chemotherapy for breast cancer
Mené en Italie sur 2 091 patientes atteintes d'un cancer du sein de stade précoce avec envahissement ganglionnaire, cet essai de phase III évalue l'efficacité, du point de vue de la survie sans maladie, et la toxicité de l'ajout de fluorouracile à un traitement adjuvant combinant épirubicine, cyclophosphamide et paclitaxel
Development of adjuvant treatment for early breast cancer has been a slow and resource-intensive process. Risk–benefit analyses call for high numbers of cumulative patient-observation-years to obtain a sufficient number of relapses for provision of adequate statistical power, and to detect short-term and long-term toxic effects. With the improving prognosis of many breast cancer subtypes, even large relative improvements result in only small absolute improvements in outcomes, which have to be carefully weighed against infrequent but clinically relevant toxic effects (eg, secondary malignancies or cardiac damage).
The Lancet , commentaire, 2014