Epirubicin and docetaxel as neoadjuvant treatment of hormone receptor positive, HER-2 negative breast cancer: findings from two successive phase II studies

Abstract

BackgroundWe report on the activity of the combination of epirubicin and docetaxel given in neoadjuvant setting for 4 and 8 cycles respectively in 2 successive series of patients with large operable or locally advanced, hormone receptor positive, HER-2 negative breast cancer.Patients and methodsPatients were treated from 2002 to 2006 with epirubicin 90 mg/m2 and docetaxel 75 mg/m2 intravenously, every 3 weeks for 4 cycles before and 4 cycles after surgery (Series I – 13 patients), and from 2006 to 2010 with the same regimen administered for 8 cycles preoperatively (Series II – 37 patients), plus hormonal therapy for 5 years and radiation therapy if indicated. All Series I and 32 Series II patients were able to complete the preoperative chemotherapy.ResultsA complete response was found in 1 patient from Series I and 13 patients from Series II and the partial remission in 10 patients from Series I and 21 patients from Series II. Two Series I and 3 Series II patients did not respond clinically. Response rate (Series I/Series II) was 84/92%. All 50 patients underwent surgery. In Series I patients, 3 pCR occurred in the breast and the axilla was histologically negative in 2 cases. No evidence of disease both in the breast and in the axilla was achieved in 7.6% (1/13) of patients. In Series II patients, 8 pCR occurred in the breast and axilla was histologically negative in 15 patients. No evidence of disease both in the breast and in the axilla occurred in 10.8% (4/37) of patients. G3–G4 toxicity included myelosuppression in 3 patients from Series I and all patients from Series II, and mucositis in 1 patient from Series I and 4 patients from series II. No other G3–4 toxicities or toxic deaths occurred. Five-year progression free survival was 38% and 90% in Series I and Series II patients respectively.ConclusionsThe incidence of pathologic complete remissions was lower in our patient population, compared to reported data. A longer duration of the preoperative treatment might be associated with a longer progression-free survival.

Release of growth factors after mechanical and chemical pleurodesis for treatment of malignant pleural effusion: a randomized control study

“…We excluded from the study patients who were due to an underlying disease or concomitant diseases not fit to undergo surgery under general anaesthesia or had a trapped lung. Their demographic data and history as well as prognostic factors that could affect the treatment outcome in different oncological patients (age 20 , 21 , type of tumour 16 , 22 , time interval from previous surgical treatment till pleurodesis, specific systemic oncological therapy 22 , 23 , performance status 22 , 24 , maximal volume of previous thoracentesis 25 ) were collected ( Table 1 ).…”

Effectiveness of adjuvant trastuzumab in daily clinical practice

“… 2 Using this tool as well as by classical clinico-pathological parameters four types of BCs can be distinguished and human epidermal growth factor receptor 2 (HER2) positive type is one of them, representing about 15% of newly diagnosed invasive BCs. 2 – 4 It is a unique entity with an aggressive behaviour, characterized by over-expression of HER2 receptor and/or HER2 gene amplification. 3 , 5 At the beginning of this century, trastuzumab, a humanized monoclonal antibody, that targets HER2 receptor, was approved for the treatment of patients with metastatic HER2-positive BC.…”