Cyclophosphamide-free adjuvant chemotherapy for ovarian protection in breast cancer patients

The randomized phase 3 SPECTRUM study at Fudan University (Shanghai, China) evaluated cyclophosphamide-free adjuvant chemotherapy for ovarian protection in young patients with ER-positive HER2-negative breast cancer. Patients were randomized to adjuvant epirubicin-cyclophosphamide followed by weekly paclitaxel (EC-wP) or epirubicin-paclitaxel followed by weekly paclitaxel (EP-wP). The rate of menstrual resumption at twelve months after chemotherapy was 48.3% with EC-wP versus 63.1% with EP-wP (p<0.001). The 5-year DFS was 78.3% with EC-wP versus 84.7% with EP-wP (p=0.07).