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

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 .  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 ) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.