This is a prospective, open-label, randomized, phase III trial. Patients will be stratified after breast surgery, as per investigational site; menopausal status; node negative diagnosis, as per sentinel-node technique versus lymphadenectomy; hormone receptor status (positive versus negative).
Patients will be randomized to: * Fluorouracil, doxorubicin, and cyclophosphamide (FAC) x 6 (cycles): 5-fluorouracil 500 mg/m2 + doxorubicin 50 mg/m2 + cyclophosphamide 500 mg/m2 day 1, every 3 weeks, for 6 cycles. * FAC x 4 (cycles) → Paclitaxel x 8 (cycles): 5-fluorouracil 500 mg/m2 + doxorubicin 50 mg/m2 + cyclophosphamide 500 mg/m2 day 1, every 3 weeks, for 4 cycles, followed by 8 administrations of weekly paclitaxel 100 mg/m2 Premenopausal women with hormone receptor positive tumors must receive tamoxifen 20 mg daily for 5 years, after the end of chemotherapy. Postmenopausal women with hormone receptor positive tumors are allowed to receive aromatase inhibitors as initial adjuvant hormone therapy or after tamoxifen. All patients with breast conservative surgery must receive radiotherapy. Estimated 5-year disease-free survival in the control arm (FAC x 6) is expected to be 80%. It is expected that disease-free survival will increase by 5% in the experimental arm (FAC-paclitaxel). 906 patients per arm must be recruited, to detect this difference with an alpha error of 0.05 and 80% power. Assuming a 6% post-randomization drop-out rate, 960 patients per arm are needed, 1920 in total.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
1,925
Arm A: FAC Arm B: FAC-wP
Arm A: FAC Arm B: FAC-wP
Arm A: FAC Arm B: FAC-wP
Disease-free Survival (DFS) Event
DFS is defined as the evidence of local, regional or metastatic recurrence, second primary cancer (with the exception of carcinoma of squamous cells or basal cells of the skin, cervical carcinoma in situ or lobular or ductal carcinoma in situ of the breast) or death for any reason.
Time frame: Up to 5 years
Overall Survival (OS) Event
OS event is defined as the death from any cause.
Time frame: Up to 5 years
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Arm B: FAC-wP
Hospital General Univ. De Elche
Elche, Alicante, Spain
Hospital General de Elda
Elda, Alicante, Spain
Complejo Hospitalario de Manresa
Manresa, Barcelona, Spain
Consorci Sanitari Parc Tauli
Sabadell, Barcelona, Spain
Hospital del Espíritu Santo
Santa Coloma de Gramenet, Barcelona, Spain
Consorci Sanitari Terrassa
Terrassa, Barcelona, Spain
Hospital Mutua Terrassa
Terrassa, Barcelona, Spain
Hospital General Jerez de la Frontera
Jerez de la Frontera, Cadiz, Spain
Hospital Provincial de Castellón
Castellon, Castellón, Spain
Hospital Comarcal de Barbastro
Barbastro, Huesca, Spain
...and 58 more locations