Cochrane · systematic review · CD012873
Sequencing of anthracyclines and taxanes in neoadjuvant and adjuvant therapy for early breast cancer
Zaheed, M, Wilcken, N, Willson, ML, et al. · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
Breast CancerAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
13
current version
GRADE rated
10
No studies
3
Included studies
NR
No studies 3 · 23.1%Ungraded 0 · 0%Very low 0 · 0%Low 2 · 15.4%Moderate 6 · 46.2%High 2 · 15.4%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Taxane followed by anthracyclines compared to anthracyclines followed by taxane in neoadjuvant therapy for early breast cancer
Population: neoadjuvant therapy for early breast cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival ( Taxane followed by anthracyclines vs anthracyclines followed by taxane | HR 0.8 [0.6, 1.08] | 2 studies · 947 participants | Moderate Downgraded: imprecision, indirectness |
Disease‐free survival ( Taxane followed by anthracyclines vs anthracyclines followed by taxane | HR 0.84 [0.65, 1.09] | 1 study · 828 participants | Moderate Downgraded: imprecision |
Pathological complete response (no invasive cancer in breast or axilla) ( Taxane followed by anthracyclines vs anthracyclines followed by taxane | RR 1.15 [0.96, 1.38] | 4 studies · 1280 participants | High |
Adverse events: neutropenia (grade 3/4) ( Taxane followed by anthracyclines vs anthracyclines followed by taxane | RR 1.25 [0.86, 1.82] | 1 study · 280 participants | Moderate Downgraded: imprecision |
Adverse events: neurotoxicity (grade 3/4) ( Taxane followed by anthracyclines vs anthracyclines followed by taxane | RR 0.95 [0.55, 1.65] | 2 studies · 1108 participants | Low Downgraded: risk of bias, imprecision |
Treatment adherence (defined as dose reduction) ( Taxane followed by anthracyclines vs anthracyclines followed by taxane | RR 0.81 [0.59, 1.11] | 1 study · 280 participants | Moderate Downgraded: risk of bias, imprecision |
Quality of life Taxane followed by anthracyclines vs anthracyclines followed by taxane | no estimate extracted | NR | No studies |
Taxane followed by anthracyclines compared to anthracyclines followed by taxane in adjuvant therapy for early breast cancer
Population: adjuvant therapy for early breast cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall survival Taxane followed by anthracyclines vs anthracyclines followed by taxane | no estimate extracted | NR | No studies |
Disease‐free survival Taxane followed by anthracyclines vs anthracyclines followed by taxane | no estimate extracted | NR | No studies |
Adverse events: neutropenia (grade 3/4) ( Taxane followed by anthracyclines vs anthracyclines followed by taxane | RR 0.62 [0.4, 0.97] | 4 studies · 279 participants | High |
Adverse events: neurotoxicity (grade 3/4) ( Taxane followed by anthracyclines vs anthracyclines followed by taxane | RR 0.78 [0.25, 2.46] | 3 studies · 162 participants | Low Downgraded: risk of bias, imprecision |
Treatment adherence (defined as dose delay) ( Taxane followed by anthracyclines vs anthracyclines followed by taxane | RR 0.76 [0.52, 1.12] | 3 studies · 238 participants | Moderate Downgraded: risk of bias, imprecision |
Quality of life ( Taxane followed by anthracyclines vs anthracyclines followed by taxane | no estimate extracted | 1 study · 20 participants | Moderate Downgraded: risk of bias, imprecision |