Neoadjuvant docetaxel followed by adjuvant doxorubicin and cyclophosphamide in patients with stage III breast cancer

Abstract

Background: To evaluate clinical and pathologic response to neoadjuvant docetaxel therapy in patients with stage III breast cancer. Patients and methods: Forty-five patients were planned to receive four cycles of docetaxel 100 mg/m 2 every 3 weeks, followed by surgery, four cycles of doxorubicin 60 mg/m 2 and cyclophosphamide 600 mg/m 2 (AC) every 3 weeks, radiation therapy (RT), and tamoxifen when indicated.Results: After four cycles of neoadjuvant docetaxel, the clinical response rate within the breast was 59% (95% CI 42% to 73%) and overall (breast and axilla) was 49% (95% CI 38% to 72%) in the intention-to-treat (ITT) population. At the time of surgery, 10% (n = 4) of patients had a pathologic complete response (pCR) in the breast, 27% (n = 11) had a pCR within the axillary lymph nodes, and 7% (n = 3) had a pCR in the breast and axilla (95% CI 2% to 21%). An additional 5% (n = 2) had minimal residual invasive tumor (<5 mm). The 5-year overall survival rate was 80%. The percentage of patients with grade 3/4 neutropenia was similar during docetaxel (93%) and AC (86%), while a greater percentage of patients had febrile neutropenia during docetaxel treatment (27%) compared with AC treatment (7%). Conclusions: Neoadjuvant docetaxel followed by surgery, adjuvant AC, hormonal therapy where indicated, and RT is an active regimen for patients with stage III breast cancer.

Genomic predictors of response to doxorubicin versus docetaxel in primary breast cancer

“…The few neoadjuvant studies conducted to-date with single agent doxorubicin or docetaxel reported a very similar activity [23][24][25]. In our trial, ER negative status was a strong but unspecific predictor of sensitivy to either docetaxel and doxorubicine.…”

Primary endocrine therapy in locally advanced breast cancers - Nottingham experience

“…However the report confirms that in this subgroup of patients, primary endocrine therapy has excellent survival outcome compared to other approaches of treatment i.e. multimodal treatment using chemotherapy (60-80% overall 5 year survival) [16][17][18][19][20].…”

Biomarker Analysis of Neoadjuvant Doxorubicin/Cyclophosphamide Followed by Ixabepilone or Paclitaxel in Early-Stage Breast Cancer

“…[27][28][29][30][31]. Ixabepilone has a similar, but distinct, mechanism of action to that of taxanes and appears to be less sensitive to mechanisms that confer taxane resistance (32,33).…”