Neoadjuvant sequential epirubicin and docetaxel followed by surgery-radiotherapy and post-operative docetaxel or gemcitabine/vinorelbine combination based on primary response: a multimodality approach for locally advanced breast cancer

Kountourakis, Panteleimon; Missitzis, Ioannis; Doufexis, Dimitrios; Zobolas, V.; Pissakas, George; Arnogiannaki, Niki; Maliou, Savoula; Sotiropoulou, Anastasia; Ardavanis, Alexandros

doi:10.1007/s00432-010-0878-8

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“…While tumor size, the presence of inflammatory carcinoma and lymph node involvement are the main prognostic factors of women with locally advanced breast cancer, the prognostic value of estrogen receptor (ER), progesterone (PR) and HER2 status has not been fully clarified (8). In the present study, between April 2012 and February 2014, 14 hormone receptor-negative patients with local breast cancer (triple-negative type, 9 patients; HER2 type, 5 patients) were treated with a fluorouracil (5-FU), epirubicin and cyclophosphamide regimen (FEC), followed by weekly paclitaxel and/or trastuzumab administration.…”

Section: Introductionmentioning

confidence: 99%

Pathological complete response rate in hormone receptor-negative breast cancer treated with neoadjuvant FEC, followed by weekly paclitaxel administration: A retrospective study and review of the literature

Kiba¹,

Morii²,

Takahashi³

et al. 2016

Oncology Letters

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Abstract. While tumor size, the presence of inflammatory carcinoma and lymph node involvement are the main prognostic factors of women with locally advanced breast cancer, the prognostic value of the estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 (HER2) status has not been fully clarified. The present study examined the therapeutic efficacy of a neoadjuvant fluorouracil, epirubicin and cyclophosphamide regimen (FEC), followed by weekly paclitaxel and/or trastuzumab administration, in the treatment of hormone receptor-negative breast cancer patients. Between April 2012 and February 2014, 14 patients with hormone receptor-negative local breast cancer (triple-negative type, 9 patients; HER2 type, 5 patients) were included in the study. In all cases, the histological type of the primary cancer was invasive ductal carcinoma. Among the 14 women who received the regimen, 5 presented with stage I cancer (35.7%), 3 with stage IIA (21.4%), 3 with stage IIB (21.4%), 1 with stage IIIB (7.1%) and 2 with stage IIIC (14.3%), according to the American Joint Committee on Cancer staging system. With regard to the tumor-node-metastasis classification, 5 patients were T1N0M0 (35.7%), 3 were T2N0M0 (21.4%), 3 were T2N1M0 (21.4%), 2 were T3N3M0 (14.3%) and 1 was T4N1M0 (7.1%). The pathological response was evaluated using resected tissue following neoadjuvant chemotherapy, according to the criteria established by the Japanese Breast Cancer Society. Patients were classified into pathological responders (grades 2 and 3, 71.4% of all patients) and non-responders (grade 1, 28.6% of all patients). A pathological complete response (pCR) was achieved in 50.0% of all cases (7/14); 44.4% of triple-negative-type cases (4/9) and 60.0% of HER2-type cases (3/5). Hematological and non-hematological toxicity was reversible and manageable. No patients withdrew from treatment, and favorable compliance was achieved. The present study demonstrated that neoadjuvant FEC followed by weekly administration of paclitaxel and/or trastuzumab induces a high pathological response and a high pCR rate in patients with hormone receptor-negative breast cancer. Due to the high clinical benefit rate and acceptable safety profile, this regimen should be considered an acceptable neoadjuvant treatment option for hormone receptor-negative breast cancer. IntroductionNeoadjuvant therapy is a standard treatment option for breast cancer (1). It has been suggested that taxane-based chemotherapy is closely associated with improved outcomes in hormone receptor-negative or human epidermal growth factor receptor 2 (HER2)-positive disease, and little, if any, benefit from taxane-based chemotherapy has been observed for the ≥50% of patients with hormone receptor-positive and HER2-negative disease (2).Paclitaxel is considered a fundamental drug in the treatment of breast cancer (3). As a potent mitotic inhibitor, it used as an effective chemotherapeutic agent in the treatment of solid tumors. A randomized phase III trial reported that paclitaxel...

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Section: Introductionmentioning

confidence: 99%