Pathological response rate in hormone-positive breast cancer patients treated with neoadjuvant FEC and triweekly docetaxel: a case series

Abstract

We recently reported that neoadjuvant 5-FU, epirubicin, and cyclophosphamide (FEC) followed by weekly paclitaxel and/or trastuzumab induced a high pathological complete response (pCR) rate in hormone-negative patients. The present study examined the therapeutic efficacy of neoadjuvant FEC followed by triweekly docetaxel and/or trastuzumab in the treatment of hormone-positive patients. Between February 2012 and December 2013, 16 hormone-positive patients with local breast cancer (luminal A type: six patients; luminal B type: two patients; luminal HER2 type: eight patients) were included in the study. The histological type of the primary cancer was invasive ductal carcinoma in all patients. The cancer stages in the 16 women who received this regimen were stage I in five (31.3%), IIA in four (25.0%), IIB in five (31.3%), IIIB in one (6.3%), and IIIC in one (6.3%). Regarding clinical TNM classification, five patients were T1N0M0, one was T1N1M0, three were T2N0M0, five were T2N1M0, one was T3N2M0, and one was T4N0M0. The pCR was evaluated using resected tissue after neoadjuvant chemotherapy according to the evaluation criteria of the Japanese Breast Cancer Society. Patients were classified into pathologic responders (grade 2: 50.0% of all patients: 2/6 of luminal A type; 6/8 of Luminal HER2 type) and nonresponders (grades 0 and 1: 50.0% of all patients: 4/6 of luminal A type; 2/2 of luminal B type; 2/8 of luminal HER2 type) according to the grade of the tumor. The pCR rate was 0%. Hematologic and nonhematologic toxicity was reversible and manageable. This study demonstrated that neoadjuvant FEC followed by triweekly docetaxel and/or trastuzumab did induce a high pathologic response in luminal HER2 type, but not in luminal A and B types, and did not induce a high pCR rate in the hormone-positive patients.

Examination of the clinical efficacy of eribulin and trastuzumab in HER2-positive recurrent breast cancer

“…The status of pre-treatment ER and PgR was assessed by immunohistochemistry (IHC), and HER2 status was assessed by either fluorescent in situ hybridization or a validated IHC method, as previously described (14)(15)(16). Patients with HER2-receptor overexpression at the 3 + level (PATHWAY ® HER2, clone 4B5; Ventana Medical Systems Inc., Tucson, AZ, USA) were immediately eligible for inclusion.…”

“…Patients with HER2-receptor overexpression at the 3 + level (PATHWAY ® HER2, clone 4B5; Ventana Medical Systems Inc., Tucson, AZ, USA) were immediately eligible for inclusion. When immunostaining was observed in >1% of tumor nuclei, the tumor was considered positive for the ER or PgR (16). Breast cancers were classified into five subtypes, as previously described (16).…”

“…When immunostaining was observed in >1% of tumor nuclei, the tumor was considered positive for the ER or PgR (16). Breast cancers were classified into five subtypes, as previously described (16).…”