Quimioterapia neoadjuvante e resposta patológica: coorte retrospectiva

Abstract

Objective:To evaluate the complete pathologic response attained by patients diagnosed with locally advanced breast cancer submitted to neoadjuvant chemotherapy based on the doxorubicin/ cyclophosphamide regimen followed by paclitaxel.Methods:A retrospective cohort of patients with locally advanced breast cancer, admitted to the Hospital de Câncer de Barretos between 2006 and 2008 submitted to the doxorubicin/cyclophosphamide protocol followed by paclitaxel (4 cycles of doxorubicin 60mg/m2 and cyclophosphamide 600mg/m2 every 21 days; 4 cycles of paclitaxel 175mg/m2 every 21 days). The following variables were assessed: age, menopause, performance status, initial clinical staging, anthropometric data, chemotherapy (dose – duration), toxicity profile, post-treatment staging, surgery, pathologic complete response rate, disease-free survival, and pathological characteristics (type and histological degree, hormonal profile and lymph node involvement). Statistical analysis was performed using a 5% level of significance.Results:Of the 434 patients evaluated, 136 were excluded due to error in staging or because they had received another type of chemotherapy. Median age was 50 years, all with performance status 0-1. Median initial clinical size of tumor was 65mm and the median final clinical size of the tumor was 22mm. Fifty-one (17.1%) patients experienced a pathologic complete response. Those with a negative hormonal profile or who were triple-negative (negative Her-2 and hormonal profile) experienced a favorable impact on the pathologic complete response.Conclusion:Neoadjuvant chemotherapy with doxorubicin/ cyclophosphamide followed by paclitaxel provided a pathologic complete response in the population studied in accordance with that observed in the literature. Triple-negative patients had a greater chance of attaining this response.

Inhibition of TFF3 Enhances Sensitivity—and Overcomes Acquired Resistance—to Doxorubicin in Estrogen Receptor-Positive Mammary Carcinoma

“…Despite the advances in MC treatment, the use of conventional chemotherapies, particularly those containing anthracyclines, remains important in the treatment of all MC subtypes [1] Indeed, neo-adjuvant chemotherapy remains the standard care for patients with locally advanced MC [2], where the use of an anthracycline containing regimen achieved a pathological complete response of 17.1% [3]. As an adjuvant therapy, the use of anthracycline containing regimens also significantly improved the 10-year recurrence free survival by 8% as well as produced a 5% reduction in MC mortality [4].…”

Análise da resposta patológica do câncer de mama em pacientes submetidas a terapia neoadjuvante em uma clínica privada de Cascavel/PR

“…Dentre as 29 mulheres selecionadas o índice de remissão completa da doença foi alcançado em um total de 13 pessoas (44,82%), taxa que se apresentou maior do que comparado em demais pesquisas analisadas (Fayanju et al, 2018;Andrade et al, 2013;TAN et al, 2009). Em um estudo de coorte retrospectivo realizado no Brasil de pacientes com o diagnóstico de câncer de mama localmente avançado, foram analisadas ao todo 298 pessoas, chegando a uma taxa de 17,1% de PCR de tumor primário e de linfonodos acometidos (Andrade et al, 2013).…”

“…Dentre as 29 mulheres selecionadas o índice de remissão completa da doença foi alcançado em um total de 13 pessoas (44,82%), taxa que se apresentou maior do que comparado em demais pesquisas analisadas (Fayanju et al, 2018;Andrade et al, 2013;TAN et al, 2009). Em um estudo de coorte retrospectivo realizado no Brasil de pacientes com o diagnóstico de câncer de mama localmente avançado, foram analisadas ao todo 298 pessoas, chegando a uma taxa de 17,1% de PCR de tumor primário e de linfonodos acometidos (Andrade et al, 2013). Resultado este que é semelhante a pesquisa realizada com 20.000 pacientes com câncer de mama da National Cancer Data Base dos Estados Unidos (NCDB), em que foi possível identificar uma PCR de mama e linfonodos axilares em 19,2% (n=6.370) dos pacientes, os quais possuíam estágios clínicos que variavam de 1 a 3 (Fayanju et al, 2018).…”

Perfil Populacional De Pacientes Que Iniciaram Terapia Neoadjuvante Para Neoplasia Mamária No Hospital Universitário São Francisco De Assis, Bragança Paulista, No Período De 2020 A 2021

“…Ao analisar a resposta patológica, apesar de não ter sido identificado resultado estatisticamente significativo (30%), na presente pesquisa a frequência identificada foi superior à observada por Andrade et al (2013), cujos resultados alcançaram 17% de similaridade, considerando os tipos cirúrgicos, o estadiamento e o tipo de quimioterapia em uso.…”