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January 2, 2024Open Access

The survival benefit of Pegylated Liposomal Doxorubicin-Based Neoadjuvant Chemotherapy in the management of breast cancer

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Key result

Pegylated liposomal doxorubicin linked to ~48% lower disease recurrence risk versus epirubicin in breast cancer.

  • HR 0.52
  • 95% CI 0.30-0.92
  • P=0.0227
  • n=304

Why the study?

The short-term outcomes, prognosis, and cardiac safety of pegylated liposomal doxorubicin-based neoadjuvant chemotherapy compared to epirubicin-based therapy in breast cancer remained to be evaluated.

Does Pegylated Liposomal Doxorubicin-based neoadjuvant chemotherapy improve overall and disease-free survival compared to epirubicin-based therapy in patients with stage II-III breast cancer?

Population

304 patients diagnosed with stages II and III breast cancer

Comparison

PLD-based NAC vs epirubicin-based NAC

Authors

RLRuoyang LiHebei Medical UniversityXZXuewei ZhaoTongji UniversityYHYunfei HuangColumbia University

Discussion

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Implication

May support PLD preference in neoadjuvant breast cancer; hypothesis-generating pending randomized confirmation.

Study Design

Type

Cohort (n=304)

Multicenter

No

Structured PICO

Does Pegylated Liposomal Doxorubicin-based neoadjuvant chemotherapy improve overall and disease-free survival compared to epirubicin-based therapy in patients with stage II-III breast cancer?

P
Population
304 patients with stage II-III breast cancer who received neoadjuvant chemotherapy, followed for a median of 58 months.
E
Exposure
Pegylated Liposomal Doxorubicin (PLD) 40 mg/m² plus cyclophosphamide 600 mg/m² on day 1 of a 21-day cycle, followed by 4 cycles of docetaxel 85 mg/m² on day 1 of a 21-day cycle.
C
Comparator
Epirubicin 90-100 mg/m² plus cyclophosphamide, followed by docetaxel (mirroring the PLD protocol).
O
Outcome
Overall survival (OS) and disease-free survival (DFS)hard clinical

Main Result

Hazard Ratio: 0.52 (95% CI 0.3–0.92)

Absolute Event Rate: 84.5% vs 72.9%

p-value: p=0.0227

PLD-based neoadjuvant chemotherapy significantly improves disease-free and overall survival compared to epirubicin in stage II-III breast cancer, without increasing cardiotoxicity.

Limitations

  • Retrospective design
  • Lack of prospective randomization
  • Small sample size
  • All patients enrolled were Chinese, making conclusions potentially inapplicable to other ethnicities
  • All patients enrolled were Chinese, making conclusions potentially inapplicable to other ethnicity groups

Cite This Study

Li et al. (2024) conducted a cohort in Stages II and III breast cancer (n=304). Pegylated Liposomal Doxorubicin (PLD) vs. Epirubicin was evaluated on 5-year Disease-Free Survival (DFS) (HR 0.52, 95% CI 0.30-0.92, p=0.0227). Pegylated liposomal doxorubicin-based neoadjuvant chemotherapy significantly reduced the risk of disease recurrence by 48% (HR 0.52) compared to epirubicin-based therapy in patients with stage II-III breast cancer.

synapsesocial.com/papers/6a214966570f73dd9ac3e4dfhttps://doi.org/10.21203/rs.3.rs-3812203/v1
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparisons of Cardiotoxicity and Efficacy of Anthracycline-Based Therapies in Breast Cancer: A Network Meta-Analysis of Randomized Clinical Trials2019 · 36 citations
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  3. 3Overall Survival Results of a Trial Assessing Patient-Reported Outcomes for Symptom Monitoring During Routine Cancer Treatment2017 · 2,388 citations
  4. 4Pegylated liposomal doxorubicin plus cyclophosphamide followed by docetaxel as neoadjuvant chemotherapy in locally advanced breast cancer (registration number: ChiCTR1900023052)2019 · 21 citations
  5. 5Improvements in US Breast Cancer Survival and Proportion Explained by Tumor Size and Estrogen-Receptor Status2015 · 71 citations