Neoadjuvant Chemotherapy With Nab-paclitaxel in Women With HER2-negative High-risk Breast Cancer

In this study, eligible and consenting patients will be randomized to receive either 4 cycles of weekly abraxane (nab-paclitaxel) followed by 4 cycles of an anthracycline-containing regimen or 4 cycles of weekly paclitaxel followed by 4 cycles of an anthracycline-containing regimen.The anthracycline regimen (AC, EC or FEC) will be chosen by the investigator at the participating sites. Before randomization patients will be stratified according to Disease stage \[operable (tumor stage: T2N0-1; T3N0) and locally advanced (T3N1;T4, any N2-3)\] and Tumor subtype \[luminal B intermediate (HER2 negative, ER or PGR positive, Ki67 from 14% to 20%) vs luminal B high (HER2 negative, ER or PGR positive, Ki67 \>20%) vs triple negative tumors (HER2 negative, ER negative and PgR negative, Ki67 any value)\]. Tumor subtype will be confirmed at two selected referral laboratories. Neoadjuvant chemotherapy will be followed by definite surgery and irradiation as per international and local guidelines. During neoadjuvant chemotherapy patients will be assessed for safety and efficacy as detailed in the protocol. After definite surgery patients will be followed for approximately 10 years according to local procedures