{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T08:22:16Z","timestamp":1782375736288,"version":"3.54.5"},"reference-count":30,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"23","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2017,8,10]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>Administration of anthracycline and taxane therapy in the adjuvant setting is considered a standard for breast cancer. We evaluated a non\u2013anthracycline-based regimen in TOP2A-normal patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>In this multicenter, open-label, phase III trial, 2,012 women with early TOP2A-normal breast cancer and at least one high-risk factor were randomly assigned to receive six cycles of docetaxel (75 mg\/m<jats:sup>2<\/jats:sup>) and cyclophosphamide (600 mg\/m<jats:sup>2<\/jats:sup>) every 3 weeks (DC) or three cycles of epirubicin (90 mg\/m<jats:sup>2<\/jats:sup>) and cyclophosphamide (600 mg\/m<jats:sup>2<\/jats:sup>) followed by three cycles of docetaxel (100 mg\/m<jats:sup>2<\/jats:sup>; EC-D). The primary end point was disease-free survival (DFS) after a median of 5 years of follow-up. Secondary end points were patient-reported toxicity, overall survival (OS), and distant disease\u2013free survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At a median estimated potential follow-up of 69 months, 5-year DFS was 87.9% (95% CI, 85.6% to 89.8%) in the EC-D arm and 88.3% (95% CI, 86.1% to 90.1%) in the DC arm. There was no significant difference in the risk of DFS events (hazard ratio [HR], 1.00; 95% CI, 0.78 to 1.28; P = 1.00), distant disease\u2013free survival (HR, 1.12; 95% CI, 0.86 to 1.47; P = .40), or mortality (HR, 1.15; 95% CI, 0.83 to 1.59; P = .41) in the intent-to-treat analysis. A significant interaction between menopausal status and treatment group was observed for DFS ( P = .04) but not for OS ( P = .07). Patients with grade 3 tumors derived most benefit from DC, and patients with grade 1 to 2 tumors derived most benefit from EC-D (DFS: interaction P = .02; and OS: interaction P = .03). Patients receiving EC-D reported significantly more stomatitis, myalgia or arthralgia, vomiting, nausea, fatigue, and peripheral neuropathy, whereas edema was more frequent after DC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provides evidence to support no overall outcome benefit from adjuvant anthracyclines in patients with early TOP2A-normal breast cancer.<\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2017.72.3494","type":"journal-article","created":{"date-parts":[[2017,6,29]],"date-time":"2017-06-29T19:59:42Z","timestamp":1498766382000},"page":"2639-2646","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":57,"title":["Adjuvant Cyclophosphamide and Docetaxel With or Without Epirubicin for Early<i>TOP2A<\/i>-Normal Breast Cancer: DBCG 07-READ, an Open-Label, Phase III, Randomized Trial"],"prefix":"10.1200","volume":"35","author":[{"given":"Bent","family":"Ejlertsen","sequence":"first","affiliation":[{"name":"Bent Ejlertsen, Maj-Britt Jensen, and Henning T. Mouridsen, Danish Breast Cancer Cooperative Group, Rigshospitalet; Ann Soegaard Knoop and Michael Andersson, Rigshospitalet; Malgorzata K. Tuxen, Eva Balslev, Dorte L. Nielsen, and Dorte Carlsen, Herlev and Gentofte Hospital, Copenhagen; Erik Hugger Jakobsen, Troels Bechmann, and Else Maae, Lillebaelt Hospital, Vejle; Inger H\u00f8jris and Hanne Melgaard Nielsen, Aarhus University Hospital, Aarhus; Marianne Ewertz, Odense University Hospital, Institute of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malgorzata K.","family":"Tuxen","sequence":"additional","affiliation":[{"name":"Bent Ejlertsen, Maj-Britt Jensen, and Henning T. Mouridsen, Danish Breast Cancer Cooperative Group, Rigshospitalet; Ann Soegaard Knoop and Michael Andersson, Rigshospitalet; Malgorzata K. Tuxen, Eva Balslev, Dorte L. Nielsen, and Dorte Carlsen, Herlev and Gentofte Hospital, Copenhagen; Erik Hugger Jakobsen, Troels Bechmann, and Else Maae, Lillebaelt Hospital, Vejle; Inger H\u00f8jris and Hanne Melgaard Nielsen, Aarhus University Hospital, Aarhus; Marianne Ewertz, Odense University Hospital, Institute of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik Hugger","family":"Jakobsen","sequence":"additional","affiliation":[{"name":"Bent Ejlertsen, Maj-Britt Jensen, and Henning T. Mouridsen, Danish Breast Cancer Cooperative Group, Rigshospitalet; Ann Soegaard Knoop and Michael Andersson, Rigshospitalet; Malgorzata K. Tuxen, Eva Balslev, Dorte L. Nielsen, and Dorte Carlsen, Herlev and Gentofte Hospital, Copenhagen; Erik Hugger Jakobsen, Troels Bechmann, and Else Maae, Lillebaelt Hospital, Vejle; Inger H\u00f8jris and Hanne Melgaard Nielsen, Aarhus University Hospital, Aarhus; Marianne Ewertz, Odense University Hospital, Institute of..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maj-Britt","family":"Jensen","sequence":"additional","affiliation":[{"name":"Bent Ejlertsen, Maj-Britt Jensen, and Henning T. Mouridsen, Danish Breast Cancer Cooperative Group, Rigshospitalet; Ann Soegaard Knoop and Michael Andersson, Rigshospitalet; Malgorzata K. Tuxen, Eva Balslev, Dorte L. 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