Adjuvant epirubicin-paclitaxel versus epirubicin-cyclophosphamide followed by paclitaxel for HER2-negative node-positive breast cancer

Adjuvant therapy is an important and effective treatment for breast cancer. However, there is a lack of head-to-head clinical trials comparing the regimens epirubicin plus paclitaxel (EP) versus the standard regimen epirubicin and cyclophosphamide followed by paclitaxel (EC-P) in breast cancer. A noninferiority phase 3 trial in China compared adjuvant EP versus EC-P for HR-positive, HER2-negative, node-positive breast cancer. The primary end point was disease-free survival. Through a median follow-up of 93.6 months the DFS with EP was noninferior to the DFS with EC-P. The 5-year overall survival was 95% in both groups. Patients in the EP group had more frequent toxic events than those in the EC-P group. The authors conclude that these finding support the EP regimen as an effective adjuvant chemotherapy regimen for women with HER2-negative breast cancer.