Three RCTs (8,728 patients, range 1,919 to 3,511) were included in the review. Median follow-up ranged from 62.5 to 73 months.
Disease-free and overall survival: Compared with the concurrent taxane-anthracycline based regimen, sequential taxane-anthracyclines were associated with a significant reduction in disease progression or death from any cause (RR 0.90, 95% CI 0.84 to 0.98; Ι²=55%; p=0.11; three RCTs) and overall mortality (RR 0.88, 95% CI 0.79 to 0.98; Ι²=0%; three RCTs).
Toxicity: Fatigue and stomatitis were significantly increased with sequential regimens (fatigue RR 1.21, 95% CI 1.05 to 1.39 with no significant heterogeneity and stomatitis RR 1.74, 95% CI 1.39 to 2.18 with significant heterogeneity; three RCTs). Febrile neutropenia was significantly reduced with sequential regimens (RR 0.87, 95% CI 0.79 to 0.96; significant heterogeneity; three RCTs).