Phase II study of neoadjuvant treatment with doxorubicin, docetaxel, and capecitabine (ATX) in locally advanced or inflammatory breast cancer

Manga, G. Pérez; Shahi, P. Khosravi; Ureña, Miguel Mendez; Pereira, Rosa Quibén; Plaza, María Isabel Palomero; Perón, Y. Izarzugaza; Val, Ricardo González del; Carrión, Joaquín Belón; Cañón, Esperanza Pérez; Alfonso, Pilar

doi:10.1007/s12282-009-0136-6

Cited by 15 publications

(9 citation statements)

References 22 publications

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“…Comparing the taxane non-containing protocols to concomitant TE protocol in our study response rates and survival data were equivalent and analogous with results of these and other [36,37] groups. We could also confirm, that achieving pCR renders a greater probability of longer PFS and LPFS, but not significant tendency in OS data.…”

Section: Discussionsupporting

confidence: 83%

Inflammatory Breast Cancer—Comparing the Effectivity of Preoperative Docetaxel-Epirubicine Protocol to Conventional Antracycline-Containing Chemotherapy to Achieve Clinical Benefit and Complete Pathological Response

Horváth

Torday

Hitre

et al. 2010

Pathol. Oncol. Res.

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Our retrospective analysis compared the effectiveness of conventional antracycline-containing protocols (A+) and docetaxel/epirubicine (TE) as primary systemic chemotherapies (PSCT) for inflammatory breast cancer (IBC). Seventy IBC patients received either A + (n = 48) or TE (n = 22) as PSCT. The objective clinical response and clinical benefit rate of treated patients were 54.3% (A+: 54,2% vs. TE: 54,5%; p = 0,28) and 92.8% (A+: 91,7% vs. TE: 95,5%; p = 0,57), respectively. The clinical complete response rate (cCR) was 23.2% (A+: 27,1% vs. TE:4,5%; χ (2) = 4,79; p = 0,03) with 7.14% (A+: 10,4% vs. TE:0%; χ (2) = 2,47; p = 0,12) of pathological complete responses (pCR). The median progression free (PFS)/local progression free (LPFS)/overall survival (OS) was 2.0/5.4/4.0 years, respectively. Patients achieving cCR had a tendency for better survival parameters than patients with less than cCR. Response rates or survival data were not statistically different in the two chemotherapy (CT) treatment groups. The survival was not influenced by the number of CT cycles in either protocols. In this set of patients, the clinical efficacy of the two alternative primary systemic chemotherapies (A + and TE) is equivalent in the treatment of inflammatory breast cancer (IBC), despite of the significant difference in favour of A + noticed in CRs. Six cycles of CT could be enough for patients achieving CR, however sequential pre- and/or postoperative CT with non cross-resistant drugs should be considered for non-responders.

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Section: Discussionsupporting

confidence: 83%

Inflammatory Breast Cancer—Comparing the Effectivity of Preoperative Docetaxel-Epirubicine Protocol to Conventional Antracycline-Containing Chemotherapy to Achieve Clinical Benefit and Complete Pathological Response

Horváth

Torday

Hitre

et al. 2010

Pathol. Oncol. Res.

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“…These advantages may include allowing patients with inoperable cancers to become candidates for surgical resection (11, 12), targeting clinically occult micro-metastases (18), and providing an opportunity to deliver cytotoxic agents to the tumor with intact native vasculature (19). Also, several studies have shown that NAC is tolerable and significantly improves outcomes compared to surgery alone in patients who had inflammatory or locally advanced breast cancer (20, 21). Since NAC tends to be offered to patients with advanced disease, perhaps our finding that NAC is a negative predictor of FPT may be related to the fact that oncologists treating women with advanced cancer defer the discussion about fertility issues when the prognosis is poor (22).…”

Section: Discussionmentioning

confidence: 99%

“…Another interesting finding was that NAC has a broader use under research protocols at Center-1, and a higher utilization rate at that institution, even in lower stage breast cancers. At Center-1, only 35.2 % of the patients in NAC group met the informal criteria (inoperable inflammatory or locally advanced breast cancer) for NAC use (21, 23). On the other hand, NAC was used only with advanced stage cancers at Centers 2 and 3, where only 3 patients received NAC, all of whom had stage III disease, large tumors (4-6 cm) and lymph node involvement.…”

Section: Discussionmentioning

confidence: 99%

Which patients pursue fertility preservation treatments? A multicenter analysis of the predictors of fertility preservation in women with breast cancer

Kim

Oktay

Gracia

et al. 2012

Fertility and Sterility

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Objective: To evaluate predictors of undergoing fertility preservation treatment (FPT) in women with breast cancer. Design: Secondary analysis of a clinical database. Setting: Three academic fertility preservation centers. Patient(s): One hundred and eight patients with breast cancer undergoing FPT and 77 patients with breast cancer not undergoing FPT from 2005-2010. Intervention(s): None. Main Outcome Measure(s): Patients’ demographic and medical information. Result(s): Women who had FPT were older, wealthier, and had lower cancer stage compared to women who did not have FPT. The rate of the administration of neoadjuvant chemotherapy (NAC) was significantly lower in women who underwent FPT. After adjusting for age, BMI, income, cancer stage, and center, a negative correlation persisted between NAC and FPT (OR=0.091, 95 % CI 0.009-0.904). When we stratified the women by center, women at Center-1 had a significantly lower FPT rate, lower parity, higher BMI, more advanced cancer stage, and lower income compared to Centers-2 and -3. The rates of NAC were significantly higher in Center-1. Conclusion(s): While age, BMI, income, cancer stage, center and NAC appear to be associated with undergoing FPT, NAC is the only modifiable variable. Since NAC restricts the time available for FPT, oncologists may consider offering adjuvant chemotherapy, except in cases where NAC clearly improves survival, in women who are interested in FPT.

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“…Interestingly, women who received neoadjuvant chemotherapy were significantly less likely to pursue FP treatments. This finding is significant because cancer treatment plans may be modifiable and the survival gain of neoadjuvant chemotherapy in early stage breast cancer has not been validated [18]. This reinforces the importance of inter-professional collaboration to coordinate medical and FP treatments to appropriately maximize a patient's opportunity for future fertility.…”

Section: Limitations Of Current Fp Programmentioning

confidence: 99%

Building a successful fertility preservation program at a major cancer center

Kim

Mersereau

2014

J Gynecol Oncol

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Over 150,000 reproductive age individuals face fertility-threatening cancer treatments each year. Improved detection and treatment of cancer in reproductive-age patients have greatly increased the long-term survival and made it possible for these individuals to consider their long-term quality-of-life after cancer including having biologic offspring. Various methods of fertility preservation (FP) are now available for both males and females. In order to maximize FP options available to patients facing imminent gonadotoxic therapies, it is crucial that women have quick access to FP care and that providers expedite FP strategies. The overarching goal of a clinical FP program is to help patients and their physicians consider the impact of treatment on future fertility and facilitate FP efforts in what is often a limited time period before cancer treatment begins.

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Phase II study of neoadjuvant treatment with doxorubicin, docetaxel, and capecitabine (ATX) in locally advanced or inflammatory breast cancer

Abstract: ATX every 28 days for four cycles is associated with a modest activity (low pCR rate) in the neoadjuvant setting of LABC.

Cited by 15 publications

References 22 publications

Inflammatory Breast Cancer—Comparing the Effectivity of Preoperative Docetaxel-Epirubicine Protocol to Conventional Antracycline-Containing Chemotherapy to Achieve Clinical Benefit and Complete Pathological Response

Inflammatory Breast Cancer—Comparing the Effectivity of Preoperative Docetaxel-Epirubicine Protocol to Conventional Antracycline-Containing Chemotherapy to Achieve Clinical Benefit and Complete Pathological Response

Which patients pursue fertility preservation treatments? A multicenter analysis of the predictors of fertility preservation in women with breast cancer

Building a successful fertility preservation program at a major cancer center

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