Timing of paclitaxel treatment in pre-operative or post-operative does not affect survival in breast cancer patients

Background: Two epirubicin and paclitaxel-based neoadjuvant chemotherapy regimens were compared in breast cancer patients. Methods: We enrolled 309 breast cancer patients who received two types of regimens: cyclophosphamide + epirubicin dose-dense neoadjuvant chemotherapy followed by sequential postoperative paclitaxel single-drug medication, and paclitaxel + epirubicin standard neoadjuvant chemotherapy followed by two cycles of the same chemotherapy after surgery. The primary endpoint was a pathological complete response (pCR) and the secondary endpoints were disease-free and overall survival. Results: The median follow-up time was 65 months. The overall pCRs for pathological efficacy and efficacy of primary lesions were 14.4% and 29.3%, respectively (P < 0.001). The pCR of the paclitaxel + epirubicin group was significantly higher than in the cyclophosphamide + epirubicin group (17.3% vs. 9.2%; P = 0.0345), but the five-year disease-free survival rates in both groups were not significantly different (82.9% vs. 75.3%; P = 0.916). Conclusions: The results of our study indicated that the timing of paclitaxel therapy, either preoperative or postoperative, does not affect survival times in breast cancer patients.