Chemotherapy-induced nausea and vomiting (CINV) in adjuvant chemotherapy with FEC followed by Docetaxel versus anthracycline free regimen with Docetaxel/ Cyclophosphamide in early breast cancer patients – A detailed examination of various endpoints and their trajectories over time<

Background: Patients included in the SUCCESS C trial with HER2neg early breast cancer received either 3 cycles of FEC, followed by 3 cycles of docetaxel or 6 cycles of docetaxel, cyclophosphamide (DC) adjuvant chemotherapy. This analysis focuses on CINV-rates evaluating if different endpoints differed between the two regimens and how they developed over the course of cycles.

Materials and Methods: Of the 3463 patients included in the SUCCESS C trial 1508 patients were accessible for this analysis with complete cycle documentation. CINV was evaluated using a tailored questionnaire on an hourly basis for the first 5 days after receiving chemotherapy. Endpoints were no control (NC), complete response (CR, no vomiting, retching, rescue medication), complete control (CC, CR+no significant nausea) and total control (TC, CR+no nausea).

Results: 767 and 741 patients received FEC and DC, respectively, and were both examined for cycles 1 to 3 for better comparability. For patients receiving FEC TC increased from 20% (c1) to 27.6% (c3), while no control decreased from 43.8% (c1) to 37.9%. For patients receiving DC TC increased from 39.1% (c1) to 49.7% (c3), while no control decreased from 27% (c1) to 24%. In both groups, an intensive crossover between the endpoints took place.

Conclusion: This is one of the largest prospective studies on CINV, with high temporal resolution and detailed data on different endpoints. Improvement of CINV-control is shown in both groups in the first 3 cycles, possibly due to suboptimal antiemetic prophylaxis recommendations.

Publication History

Article published online:
04 June 2025