Clinical and pathological response rates of docetaxel-based neoadjuvant chemotherapy in locally advanced breast cancer and comparison with anthracycline-based chemotherapies: Eight-year experience from single centre

Gupta, Dinesh; Raina, Vinod; Rath, GK; Shukla, N.K.; Mohanti, BK; Sharma, Dheeraj

doi:10.4103/0019-509x.92258

Cited by 18 publications

(9 citation statements)

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“…7 Taxanes (docetaxel or paclitaxel) have been found to be more effective than anthracylines and have been added in the chemotherapy regimen to get better pathological response. [8][9][10] Aims and objectives of the following study were assessment of effectiveness of neoadjuvant chemotherapy to downstage locally advanced breast cancer based on clinical and radiological findings, selection of surgical procedure according to response to neoadjuvant chemotherapy and to assess the pathological response and to assess the surgical outcome of the procedure.…”

Section: Introductionmentioning

confidence: 99%

Role of neoadjuvant chemotherapy in downstaging locally advanced breast carcinoma, selection of surgical procedure and its outcome

2020

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Background: In clinical practice all cases of locally advanced breast carcinoma (LABC) warrant chemotherapy followed by multimodality care. Neoadjuvant chemotherapy (NACT) has been the mainstay in the management of LABC. The main aim of NACT is to downstage and prevent systemic micrometastasis early.Methods: This was a prospective study conducted on 36 diagnosed cases of stage III locally advanced breast cancer coming to the Dept. of Surgery, Dr. D. Y. Patil Medical College and hospital, Pune for a period of 2 years from 2017-2019. The effectiveness of neoadjuvant chemotherapy was assessed based on clinical, pathological and radiological response.Results: Among 36 LABC cases, maximum number of patients fell in the 41-50 years (41.6%) and presented in the Infiltrating ductal carcinoma group with a clinical stage IIIA disease. The response to NACT showed that a total of 12 patients (33.3%) showed complete clinical response and 30 patients were downstaged after neoadjuvant chemotherapy which was statistically significant. Only 4 out of the total 12 complete clinical responders went for Breast conservative surgery. Seroma formation was found to be the most common post-operative complication.Conclusions: LABC subjected to neoadjuvant chemotherapy based on taxanes/Anthracyclines show good clinical and radiological response. Patients preferred modified radical mastectomy due to the lack of awareness and low socioeconomic strata.The type of surgery did not increase the chance of recurrence in the follow up period.

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Section: Introductionmentioning

confidence: 99%

Role of neoadjuvant chemotherapy in downstaging locally advanced breast carcinoma, selection of surgical procedure and its outcome

2020

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“…Although there was an overall response rate of 66% with 3 cycles of neoadjuvant CEF, there was no difference in overall or disease free survival between the two arms. Gupta et al found that docetaxel was better then epirubicin in LABC in terms of pCR (Gupta et al, 2011). In our analysis, LABC constituted 37% of all cancers and NACT was admistered in one third of these.…”

Section: Discussionmentioning

confidence: 43%

Taxane and Anthracycline Based Neoadjuvant Chemotherapy for Locally Advanced Breast Cancer : Institutional Experience

Gogia

Raina²,

Deo³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: The aim of this study was to assess the response rates (clinical and pathological ) with docetaxel and epirubicin combination chemotherapy and its effect on outcome. Materials and Methods: We retrospectively analysed locally advanced breast cancer (LABC) patients who received NACT from January 2008 to December 2012 in our tertiary care centre. LABC constituted 37% of all breast cancer cases and 120 patients fulfilled the eligibility criteria. The regimens used for NACT were, six cycles of DEC (docetaxel 75 mg/m 2 , epirubicin 75 mg/ m 2 , cyclophosphamide 500 mg/m 2 on Day 1, 3 weekly) and a sequential regimen (4 cycles of FEC, 5-flurouracil 600 mg/m², epirubicin 75 mg/m², cyclophosphamide 600 mg/m² followed by 4 cycles of docetaxel 85 mg/m 2 ). Results: The median age was 47 years (range 23-72). Ninety six ( 80 %) had T4 disease and 90% had clinically palpable lymph nodes at diagnosis. The median size of primary tumor at presentation was 5.9 cm. Hormone receptor positivity was seen in 55% and HER2/neu positivity, in 25%. Triple negative breast cancers constituted 25 % of the cases. The overall clinical response rate ( complete or partial ) was 85% and pathological complete responses were obtained in 15%. Four cases defaulted, 5 patients died of treatment related toxicity and 15% developed febrile neutropenia on DEC. The median duration of follow up was 22 months. The median time to relapse was 20 months and the 3 year relapse free and overall survival rates were 50% and 70% respectively. Conclusions: LABC constituted 37% of all breast cancer cases at our institute. With NACT, pCR was seen in 15% of the cases. Sequential chemotherapy was better tolerated than concurrent anthracyline and taxane chemotherapy with a similar pCR.

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“…Our study showed an Objective Response (cCR + cPR) rate of 81.25%. OR is reported as 80.4% by Bhattacharyya et al (2014) (2) , 84.4% by Raina V et al (2011), (3) 60.36% by Gupta et al (2011) (7), 86% by Vishwambharan et al (2005), (8) 66% by Deo et al (2003), (10) 80% in NSABP B18 (1997) which included 608 patients showed that patients who received 4 cycles of doxorubicin and cyclophosphamide pre operatively.…”

Section: Total Objective Responsementioning

confidence: 98%

“…Most of the studies (Raina V et al (3), Gupta et al . (7) , Vishwambharan et al . (8) , Egwuonwu et al (9) , Deo et al (2003) (10) ) used 3 to 6 chemotherapy cycles pre-operatively, which is comparable to our study.…”

Section: Chemotherapy Regimensmentioning

confidence: 99%

A Clinical Study of Locally Advanced Carcinoma of Breast

Borkar¹,

Sheikh²

2015

jebmh

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BACKGROUND: In India it is observed that most of the patients of breast cancer clinically present in late stage due to their ignorance of disease despite so much advancement in its detection and management. Locally advanced breast cancer (LABC) accounts for 30-35% of all cases of breast cancers in India. This study aims to evaluate Clinical features, Investigations, various Treatment modalities and the Clinico-pathological correlation & outcome of various treatment modalities of LABC, with special emphasis on Neo-adjuvant chemotherapy (NACT) in Indian setting. MATERIAL AND METHOD: This was a non-randomised prospective observational study. We analyzed 57 patients of LABC Stage IIIB & IIIC presenting at Government Medical College, Nagpur, Maharashtra, a tertiary care Centre from September 2012 to November 2014. RESULTS: Stage IIIB comprised 84.21% patients while remaining 15.79% were having Stage IIIC disease. Skin involvement was observed in 91.23% patients. 15.79% showed supraclavicular lymph node involvement. 32 patients received NACT (2 to 6 cycles). Out of these 32, complete clinical response (cCR) was 12.5%, partial response (cPR) was 68.75% and pathological CR (pCR) was 6.25% with Total Objective response (cCR+cPR) 81.25%. Feasibility of Breast Conserving Surgery (BCS) was observed in 12.5% patients. 25 patients underwent primary surgery followed by adjuvant chemotherapy. Modified Radical Mastectomy was performed in 89.48% patients. CONCLUSIONS: With overall clinical response of 81.25%, neoadjuvant chemotherapy is the best treatment option for patients with Locally Advanced Breast Cancer with added advantage of in vivo testing the sensitivity of chemotherapeutic agents, early management of micrometastasis and down staging the primary tumour with feasibility of BCS. Patients presenting LABC constitute a diverse group for which a variety of treatment modalities should be instituted with coordinated treatment planning among surgeons, medical oncologists and radiation oncologists.

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Clinical and pathological response rates of docetaxel-based neoadjuvant chemotherapy in locally advanced breast cancer and comparison with anthracycline-based chemotherapies: Eight-year experience from single centre

Abstract: Although pCR rates were higher with docetaxel-based NACT, it did not translate into superior disease-free survival / overall survival compared to anthracycline-based chemotherapies.

Cited by 18 publications

References 20 publications

Role of neoadjuvant chemotherapy in downstaging locally advanced breast carcinoma, selection of surgical procedure and its outcome

Role of neoadjuvant chemotherapy in downstaging locally advanced breast carcinoma, selection of surgical procedure and its outcome

Taxane and Anthracycline Based Neoadjuvant Chemotherapy for Locally Advanced Breast Cancer : Institutional Experience

A Clinical Study of Locally Advanced Carcinoma of Breast

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