Key result
Adjuvant chemotherapy with FEC was associated with a significantly higher incidence of VTE compared with other regimens in early breast cancer (27% vs 5%; OR 7.9, 95% CI 3.3-19.2, P<0.001).
Why the study?
Does adjuvant chemotherapy with 5-fluorouracil, epirubicin, and cyclophosphamide (FEC) increase the risk of venous thromboembolism compared to other regimens in patients with early breast cancer?
Cohort (n=325)
Does adjuvant chemotherapy with 5-fluorouracil, epirubicin, and cyclophosphamide (FEC) increase the risk of venous thromboembolism compared to other regimens in patients with early breast cancer?
Adjuvant FEC chemotherapy for early breast cancer is associated with a markedly higher risk of venous thromboembolism compared to other chemotherapy regimens, suggesting a need for heightened vigilance or prophylaxis.
FEC-associated VTE risk in early breast cancer warrants vigilance; leaves open need for RCTs to confirm and guide prophylaxis.
Aim: Previous studies have shown that adjuvant chemotherapy in early breast cancer (EBC) may increase the risk of venous thromboembolism (VTE). Clinical experience suggests the combination of 5‐fluorouracil, epirubicin and cyclophosphamide (FEC) may be associated with a higher frequency of VTE than other regimens. This study aims to investigate the use of adjuvant FEC compared with other adjuvant regimens in the development of VTE in patients with EBC. Methods: A retrospective audit was conducted examining all eligible patients who received adjuvant chemotherapy for EBC in the Australian Capital Territory from 1 January 2005 to 30 June 2007. Data were collected from patients' notes, including risk factors for VTE, tumor pathology, chemotherapy details and incidence of VTE. Comparisons using χ 2 tests and independent samples t ‐tests were made between patients who received FEC and those who received another regimen. Multivariate logistic regression was used to investigate prognostic factors for the development of VTE. Results: A total of 325 patients were included in the study, of whom 176 received FEC and 149 received other adjuvant chemotherapy regimens. The incidence of VTE in patients who received FEC was 47/176 (27%), which was significantly higher than for patients who received other regimens (7/149, 5%, P < 0.001). FEC was the only significant prognostic factor for the development of VTE (OR 7.9, 95% CI 3.3–19.2, P < 0.001). Conclusion: The use of adjuvant FEC chemotherapy is associated with an increased incidence of VTE in patients with EBC compared with other commonly used chemotherapy regimens.
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Hoy et al. (2009) conducted a cohort in Early breast cancer (n=325). 5-fluorouracil, epirubicin and cyclophosphamide (FEC) vs. Other adjuvant chemotherapy regimens was evaluated on Development of venous thromboembolism (VTE) (OR 7.9, 95% CI 3.3-19.2, p=< 0.001). Adjuvant chemotherapy with FEC was associated with a significantly higher incidence of VTE compared with other regimens in early breast cancer (27% vs 5%; OR 7.9, 95% CI 3.3-19.2, P<0.001).
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