{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:16:56Z","timestamp":1790194616293,"version":"4.1.0"},"reference-count":23,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"32","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2015,11,10]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> Capecitabine is an active drug in metastatic breast cancer (BC). GEICAM\/2003-10 is an adjuvant trial to investigate the integration of capecitabine into a regimen of epirubicin and docetaxel for node-positive early BC. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> Patients with operable node-positive BC (T1-3\/N1-3) were eligible. After surgery, 1,384 patients were randomly assigned to receive epirubicin plus cyclophosphamide (EC; 90 and 600 mg\/m<jats:sup>2<\/jats:sup>, respectively, \u00d7 four cycles), followed by docetaxel (100 mg\/m<jats:sup>2<\/jats:sup> \u00d7 four cycles; EC-T) or epirubicin plus docetaxel (ET; 90 and 75 mg\/m<jats:sup>2<\/jats:sup>, respectively, \u00d7 four cycles), followed by capecitabine (1,250 mg\/m<jats:sup>2<\/jats:sup> twice a day on days 1 to 14, \u00d7 four cycles; ET-X); all regimens were given every 3 weeks. The primary end point was invasive disease-free survival. Secondary end points included safety (with an alopecia-specific study) and overall survival (OS). <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> After a median follow-up of 6.6 years and 297 events, 86% of patients who received EC-T and 82% of those who received ET-X were invasive disease free at 5 years (hazard ratio, 1.30; 95% CI, 1.03 to 1.64; log-rank P = .03). The OS difference between arms was not statistically significant (hazard ratio, 1.13; 95% CI, 0.82 to 1.55; log-rank P = .46). The most frequent grade 3 to 4 adverse events in the EC-T versus ET-X arms were neutropenia (19% v 10%), with 7% febrile neutropenia across arms; fatigue (13% v 11%); diarrhea (3% v 11%); hand-foot syndrome (2% v 20%); mucositis (6% v 5%); vomiting (both, 5%); and myalgia (4.5% v 1%). Incomplete scalp hair recovery was more frequent in the EC-T than ET-X arm (30% v 14%), and patients who received EC-T wore wigs significantly longer than those who received ET-X (8.35 v 6.03 months). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Invasive disease-free survival, but not OS, was significantly superior for patients with node-positive early BC who received the adjuvant standard schedule EC-T than for those who received the experimental ET-X regimen. Toxicity profiles differed substantially across arms. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2015.61.9510","type":"journal-article","created":{"date-parts":[[2015,9,29]],"date-time":"2015-09-29T02:53:53Z","timestamp":1443495233000},"page":"3788-3795","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":65,"title":["Epirubicin Plus Cyclophosphamide Followed by Docetaxel Versus Epirubicin Plus Docetaxel Followed by Capecitabine As Adjuvant Therapy for Node-Positive Early Breast Cancer: Results From the GEICAM\/2003-10 Study"],"prefix":"10.1200","volume":"33","author":[{"given":"Miguel","family":"Mart\u00edn","sequence":"first","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amparo","family":"Ruiz Sim\u00f3n","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Ruiz Borrego","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Ribelles","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1lvaro","family":"Rodr\u00edguez-Lescure","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"Mu\u00f1oz-Mateu","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mireia","family":"Margel\u00ed Vila","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agust\u00ed","family":"Barnadas","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; 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Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Del Barco Berron","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Jara","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; 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Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noelia","family":"Mart\u00ednez-J\u00e1\u00f1ez","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9sar","family":"Mendiola Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9sar A.","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Mart\u00ednez de Due\u00f1as","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Andr\u00e9s","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arrate","family":"Plazaola","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"de la Haba-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose Manuel","family":"L\u00f3pez-Vega","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; Amparo Ruiz Sim\u00f3n, Instituto Valenciano de Oncolog\u00eda; Ana Santaballa, Hospital Universitario La Fe; Ana Lluch,..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Encarna","family":"Adrover","sequence":"additional","affiliation":[{"name":"Miguel Mart\u00edn, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Universidad Complutense; Carlos Jara, Fundaci\u00f3n Hospitalaria de Alcorc\u00f3n; Noelia Mart\u00ednez-J\u00e1\u00f1ez, Hospital Universitario Ram\u00f3n y Cajal; C\u00e9sar Mendiola Fern\u00e1ndez, Hospital Universitario; Ana Isabel Ballesteros, Hospital de la Princesa; Maribel Casas, Mar\u00eda del Carmen C\u00e1mara, and Eva Carrasco, GEICAM Headquarters, Madrid; 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