A Phase II Study of Concurrent Docetaxel, Epirubicin and Cyclophosphamide as a Neoadjuvant Chemotherapy Regimen in Patients with Locally Advanced Breast Cancer

Abstract

Background: Neoadjuvant chemotherapy with concurrent docetaxel, doxorubicin and cyclophosphamide is commonly used for patients with locally advanced breast cancer. Epirubicin is another anthracycline used in breast cancer but the concurrent use of epirubicin and taxane is not well-established. We conducted a single institution, phase II study to assess the efficacy and safety of concurrent docetaxel, epirubicin and cyclophosphamide (TEC) as a neoadjuvant chemotherapy regimen in breast cancer. Methods: Patients with newly diagnosed locally advanced breast cancer defined as T2 >3 cm, T3, T4 with any N, or any T with N1-3 were eligible. A chemotherapy regimen of docetaxel 75mg/m2, epirubicin 75mg/m2 and cyclophosphamide 600mg/m2 was given with filgrastim support every 3 weeks for 6 cycles. The primary end-point was pathologic complete response rate. Results: Twenty patients were enrolled from 2003 to 2006. The median age was 51 (29-70) year-old. Eight patients were premenopausal. Ten patients had positive hormone receptors. Four patients had HER2 positive receptor. Nineteen patients completed six cycles of TEC chemotherapy. The pathologic complete response rate was 25%. Eight of sixteen patients with N1-3 disease had pathological negative lymph nodes. With a median follow up of 57.5 (16-71) months, four patients relapsed including one death from recurrence. The estimated 5 year relapse-free survival was 79.3% and the 5-year overall survival was 94.7%. No patient had cardiac failure or death during treatment. The most common grade 3-4 toxicity was neutropenia (35%). Conclusion: TEC regimen is a well- tolerated and effective neoadjuvant chemotherapy regimen for locally advanced breast cancer that results in a pathologic complete response rate of 25%.

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“…4 Factors which effects complete pathological response to neoadjuvant chemotherapy are age, size of the tumour, pre/peri/post-menopausal status, chemotherapy given, number of chemotherapy cycles, IHC status, lympho-vascular and perineural invasion. 5 A lot of trials have been done reporting effectiveness of anthracycline -based chemotherapy regimens over conventional regimens. 6 In one of the clinical study conducted in India for evaluation of efficacy of NACT for LABC, revealed more effectiveness of taxane-based chemotherapy as compared to anthracycline-based chemotherapy.…”

Efficacy of Moxibustion for Cancer-Related Fatigue in Patients with Breast Cancer: A Systematic Review and Meta-Analysis

“…Moreover, it offers the advantage of potentially lower toxicity levels compared to TAC chemotherapy. 61 The TEC chemotherapy regimen is typically administered to breast cancer patients at the following dosages and intervals. TEC regimen: epirubicin 60 to 75 mg/m 2 d1, cyclophosphamide 500 mg/m 2 d1, docetaxel 75 mg/m 2 d1, every 3 weeks.…”

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“…The pathologic response to NC becomes a marker for long-term survival [2,3,15]. Operations after neoadjuvant CTx create down staging, so it makes difficult for post-operative pathologic results to predict prognoses.…”