Difference between revisions of "Complex multipart regimens"
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m (→Breast cancer) |
m (→Breast cancer) |
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| Line 5: | Line 5: | ||
=Breast cancer= | =Breast cancer= | ||
==BCIRG-005== | ==BCIRG-005== | ||
| − | ===Arm 1=== | + | ===Arm 1, sequential=== |
*[[Breast_cancer#AC|AC]], then [[Breast_cancer#Docetaxel_monotherapy_2|T]] | *[[Breast_cancer#AC|AC]], then [[Breast_cancer#Docetaxel_monotherapy_2|T]] | ||
| − | ===Arm 2=== | + | ===Arm 2, concurrent=== |
*[[Breast_cancer#TAC_.28Taxotere.29|TAC]] | *[[Breast_cancer#TAC_.28Taxotere.29|TAC]] | ||
===Comparative efficacy=== | ===Comparative efficacy=== | ||
| Line 14: | Line 14: | ||
|[[Levels_of_Evidence#Efficacy|'''Efficacy''']] | |[[Levels_of_Evidence#Efficacy|'''Efficacy''']] | ||
|- | |- | ||
| − | | | + | |Sequential (AC, then T) |
|style="background-color:#ffffbf"|Seems not superior | |style="background-color:#ffffbf"|Seems not superior | ||
|- | |- | ||
| − | | | + | |Concurrent (TAC) |
|style="background-color:#ffffbf"|Seems not superior | |style="background-color:#ffffbf"|Seems not superior | ||
|- | |- | ||
| Line 25: | Line 25: | ||
==BCIRG 006== | ==BCIRG 006== | ||
| − | ===Arm 1=== | + | ===Arm 1, sequential without trastuzumab=== |
*[[Breast_cancer#AC|AC]], then [[Breast_cancer#Docetaxel_monotherapy_2|T]] | *[[Breast_cancer#AC|AC]], then [[Breast_cancer#Docetaxel_monotherapy_2|T]] | ||
| − | ===Arm 2=== | + | ===Arm 2, sequential with trastuzumab=== |
*[[Breast_cancer#AC|AC]], then [[Breast_cancer,_HER-2_positive#TH_.28Taxotere.29_2|TH]] | *[[Breast_cancer#AC|AC]], then [[Breast_cancer,_HER-2_positive#TH_.28Taxotere.29_2|TH]] | ||
| − | ===Arm 3=== | + | ===Arm 3, concurrent with trastuzumab=== |
*[[Breast_cancer,_HER-2_positive#TCH_.28Taxotere.2C_Carboplatin.29|TCH]] | *[[Breast_cancer,_HER-2_positive#TCH_.28Taxotere.2C_Carboplatin.29|TCH]] | ||
===Comparative efficacy=== | ===Comparative efficacy=== | ||
| Line 61: | Line 61: | ||
==CALGB 9741== | ==CALGB 9741== | ||
| − | ===Arm 1=== | + | ''Note: what is referred to in this study as concurrent is in fact the same regimen that is referred to as sequential in other studies.'' |
| + | ===Arm 1, sequential=== | ||
*A, then [[Breast_cancer#Paclitaxel_monotherapy_2|T]], then C | *A, then [[Breast_cancer#Paclitaxel_monotherapy_2|T]], then C | ||
| − | ===Arm 2=== | + | ===Arm 2, dose-dense sequential=== |
*ddA, then [[Breast_cancer#Paclitaxel_monotherapy_2|ddT]], then ddC | *ddA, then [[Breast_cancer#Paclitaxel_monotherapy_2|ddT]], then ddC | ||
| − | ===Arm 3=== | + | ===Arm 3, "concurrent"=== |
*[[Breast_cancer#AC|AC]], then [[Breast_cancer#Paclitaxel_monotherapy_2|T]] | *[[Breast_cancer#AC|AC]], then [[Breast_cancer#Paclitaxel_monotherapy_2|T]] | ||
| − | ===Arm 4=== | + | ===Arm 4, dose-dense "concurrent"=== |
*[[Breast_cancer#ddAC_2|ddAC]], then [[Breast_cancer#Paclitaxel_monotherapy_2|ddT]] | *[[Breast_cancer#ddAC_2|ddAC]], then [[Breast_cancer#Paclitaxel_monotherapy_2|ddT]] | ||
===Comparative efficacy=== | ===Comparative efficacy=== | ||
Revision as of 15:49, 9 December 2017
The purpose of this page is to capture information about complex comparisons that is not easily conveyed on the treatment regimen pages. Many complex multipart RCTs are of the "Y-shaped" format "A followed by B1 versus B2" or "A1 versus A2 followed by B" and this can be captured on the treatment regimen pages. This page will convey information on more complicated designs, such as "A followed by B versus B followed by A" or "A followed by B versus C followed by D".
Breast cancer
BCIRG-005
Arm 1, sequential
Arm 2, concurrent
Comparative efficacy
| Schedule | Efficacy |
| Sequential (AC, then T) | Seems not superior |
| Concurrent (TAC) | Seems not superior |
References
- Eiermann W, Pienkowski T, Crown J, Sadeghi S, Martin M, Chan A, Saleh M, Sehdev S, Provencher L, Semiglazov V, Press M, Sauter G, Lindsay MA, Riva A, Buyse M, Drevot P, Taupin H, Mackey JR. Phase III study of doxorubicin/cyclophosphamide with concomitant versus sequential docetaxel as adjuvant treatment in patients with human epidermal growth factor receptor 2-normal, node-positive breast cancer: BCIRG-005 trial. J Clin Oncol. 2011 Oct 10;29(29):3877-84. Epub 2011 Sep 12. link to original article contains verified protocol PubMed
BCIRG 006
Arm 1, sequential without trastuzumab
Arm 2, sequential with trastuzumab
Arm 3, concurrent with trastuzumab
Comparative efficacy
- Analyzed using a step-down design
Comparison 1
| Trastuzumab-containing regimens vs. AC, then T | Efficacy |
| AC, then TH | Superior OS |
| TCH | Seems to have superior OS |
Comparison 2
| Trastuzumab-containing regimens | Efficacy |
| AC, then TH | Seems not superior |
| TCH | Seems not superior |
References
- Slamon D, Eiermann W, Robert N, Pienkowski T, Martin M, Press M, Mackey J, Glaspy J, Chan A, Pawlicki M, Pinter T, Valero V, Liu MC, Sauter G, von Minckwitz G, Visco F, Bee V, Buyse M, Bendahmane B, Tabah-Fisch I, Lindsay MA, Riva A, Crown J; Breast Cancer International Research Group. Adjuvant trastuzumab in HER2-positive breast cancer. N Engl J Med. 2011 Oct 6;365(14):1273-83. link to original article link to PMC article PubMed
CALGB 9741
Note: what is referred to in this study as concurrent is in fact the same regimen that is referred to as sequential in other studies.
Arm 1, sequential
- A, then T, then C
Arm 2, dose-dense sequential
- ddA, then ddT, then ddC
Arm 3, "concurrent"
Arm 4, dose-dense "concurrent"
Comparative efficacy
- Analyzed using a 2 x 2 factorial design
Comparison 1
| Dose density | Efficacy |
| Dose-dense (q2wk) | Seems to have superior OS |
| Standard (q3wk) | Seems to have inferior OS |
Comparison 2
| Schedule | Efficacy |
| Concurrent | Seems not superior |
| Sequential | Seems not superior |
References
- Citron ML, Berry DA, Cirrincione C, Hudis C, Winer EP, Gradishar WJ, Davidson NE, Martino S, Livingston R, Ingle JN, Perez EA, Carpenter J, Hurd D, Holland JF, Smith BL, Sartor CI, Leung EH, Abrams J, Schilsky RL, Muss HB, Norton L. Randomized trial of dose-dense versus conventionally scheduled and sequential versus concurrent combination chemotherapy as postoperative adjuvant treatment of node-positive primary breast cancer: first report of Intergroup Trial C9741/Cancer and Leukemia Group B Trial 9741. J Clin Oncol. 2003 Apr 15;21(8):1431-9. Epub 2003 Feb 13. link to original article contains verified protocol PubMed