Impact of sequencing weekly paclitaxel (T) and dose-dense doxorubicin/cyclophosphamide (DDAC) on tolerability and relative dose intensity (RDI) in breast cancer (BC) patients (pts) receiving neoadjuvant chemotherapy (NAC).

1048 Background: A preferred NAC regimen for HER2-negative BC is DDAC for 4 cycles followed by 12 weeks of T. RDI of 1 indicates that all intended doses are given at the scheduled interval. While large randomized studies are lacking, few studies indicated improved pCR and/or RDI when taxanes are given first. We hypothesize that tolerability and RDI are improved when T is given before DDAC. To our knowledge, this is the first study evaluating the impact of sequence on tolerability and RDI when using DDAC/weekly T. Methods: This IRB-approved, retrospective chart review included pts with stage II-III HER2-negative BC who received DDAC/weekly T NAC at our institution between August 2012 and May 2014. The sequence was based on physician preference. Conventional sequence group (CS) included pts who received weekly T after DDAC; reverse sequence group (RS) received T before DDAC. Our primary outcomes were rate of pCR and tolerability/RDI. Results: We identified 27 pts in CS and 29 pts in RS. No statistical diffe...