Adjuvant Docetaxel-Cyclophosphamide Versus Anthracycline-Taxane Chemotherapy in Stage I-III HR-Positive/HER2-Negative Breast Cancer: A Real-World Propensity Score Overlap-Weighted Cohort Study.

Authors

Perihan Perkin, Derya Sarikaya, Hilal Karakas, Ugur Ozberk, Burak Bilgin, Efnan Algin, Oznur Bal, Didem Sener Dede, Gokhan Ucar

Published in

Journal of clinical medicine. Volume 15. Issue 21. Nov 03, 2026. Epub Nov 03, 2026.

Abstract

Background/Objectives: The optimal adjuvant chemotherapy regimen remains uncertain for some patients with hormone receptor (HR)-positive/HER2-negative early breast cancer, particularly regarding the incremental benefit of anthracyclines. We compared real-world outcomes with docetaxel-plus-cyclophosphamide (TC) and anthracycline-taxane chemotherapy. Methods: This retrospective single-center cohort included patients with stage I-III HR-positive/HER2-negative breast cancer who underwent surgery and received adjuvant TC or anthracycline-taxane chemotherapy between 2019 and 2025. Patients receiving neoadjuvant systemic therapy were excluded. Disease-free survival (DFS) was the primary outcome and overall survival (OS) the secondary outcome. Propensity score overlap weighting adjusted for measured baseline differences was used; the absolute difference in weighted 3-year DFS was the primary adjusted measure. Results: Among 361 patients, 201 received TC and 160 anthracycline-taxane chemotherapy. The anthracycline-taxane group had higher baseline clinicopathologic risk. Median follow-up was 39.0 months. Twelve DFS events occurred (TC, n = 3; anthracycline-taxane, n = 9). Unadjusted 3-year DFS was 99.0% versus 96.6% (p = 0.096), and 3-year OS was 99.4% versus 99.1% (p = 0.725). The overlap-weighted analysis included 346 patients and achieved adequate covariate balance. Weighted 3-year DFS was 99.2% with TC and 96.5% with anthracycline-taxane chemotherapy, an absolute difference of 2.68 percentage points (95% CI, -1.81 to 10.03). Sensitivity analysis yielded similar results (2.70 percentage points; 95% CI, -1.76 to 9.87). Conclusions: No statistically significant difference in 3-year DFS was demonstrated after adjustment. Limited events and relatively short follow-up preclude conclusions regarding equivalence or noninferiority. These findings support individualized adjuvant chemotherapy selection and warrant confirmation in larger cohorts with longer follow-up.

PMID:
43030711
Bibliographic data and abstract were imported from PubMed on 14 Nov 2026.

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