A trial looking at chemotherapy before surgery for breast cancer (Neo-tAnGo trial)

Cancer type:

Breast cancer




Phase 3

This trial was trying to find the best combination of drugs to treat women who have chemotherapy before surgery for breast cancer. This trial was supported by Cancer Research UK.

Doctors sometimes treat breast cancer with chemotherapy before surgery. This is called neo adjuvant chemotherapy. It can help to shrink the cancer before the surgery, so that the operation is easier and the surgeon doesn’t need to remove as much breast tissue.

For this type of treatment, doctors often give chemotherapy drugs called epirubicin, and cyclophosphamide, and sometimes paclitaxel (Taxol). They thought another drug called gemcitabine might also be useful, but they were not sure. And they were not sure which of these drugs they should give first.

The aims of this trial were to find out if adding gemcitabine would help. And to find the best order in which to give the drugs.

Summary of results

The researchers found that having paclitaxel at the beginning of chemotherapy was helpful.

The trial recruited 831 women who had stage 2, 3 or 4 breast cancer. They were put into 4 different treatment groups by a computer (a randomised trial)

  • Group 1 had 4 treatment cycles of epirubicin and cyclophosphamide (EC) first, followed by 4 cycles of paclitaxel
  • Group 2 had paclitaxel first, followed by EC
  • Group 3 had 4 cycles EC first, followed by 4 cycles of paclitaxel and gemcitabine
  • Group 4 had paclitaxel and gemcitabine first, followed by EC

In some women, all signs of cancer disappeared from the breast and lymph nodes under the arm. Doctors call this a complete response Open a glossary item.  The percentage of women who had a complete response was at least 15% in each group – this is roughly 1 in 6 women treated. But it was higher in the groups having paclitaxel first. In these groups 1 in 5 women (which is 20%) had a complete response.

In 2013 some more long term results were published. The trial team had followed up the women for an average period of nearly 4 years. At this point, they found there was no significant difference in how long women in the different groups were living without any signs of their cancer coming back. And there was also no significant difference in the average length of time that women in the different groups were living overall.

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Dr Helena Earl

Supported by

Bristol-Myers Squibb
Cancer Research UK
Eli Lilly and Company Limited
Experimental Cancer Medicine Centre (ECMC)
National Institute for Health Research Cancer Research Network (NCRN)

Other information

This is Cancer Research UK trial number CRUK/04/007.

Questions about cancer? Contact our information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:

Oracle 335

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Harriet wanted to try new treatments

Picture of Harriet

“I was keen to go on a clinical trial. I wanted to try new cancer treatments and hopefully help future generations.”

Last reviewed:

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