Docetaxel and high-dose epirubicin as neoadjuvant chemotherapy in locally advanced breast cancer

Espinosa, Enrique; Morales, Serafín; Borrega, Pablo; Casas, Adriana; Madroñal, C.; Machengs, I.; Illarramendi, JJ; Lizón, J.; Moreno, J.A.; Belon, J.; Janariz, J.; Puente, M. de la; Checa, T.; Mel, J. R.; Barón, Manuel González

doi:10.1007/s00280-004-0830-1

Cited by 22 publications

(16 citation statements)

References 25 publications

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“…Locally advanced breast cancer with large tumor lesions and more node involvement is related with a lower pCR rate as compared with early stage or operable breast cancer [13, 14]. In the present study, the overall pCR rate (12.31%) in the PE arm was comparable to those reported previously for taxane–anthracycline-based regimens (13.3%–18%) [15, 16]. Specifically, the results were similar to those of the ABCSG-14 trial, which administered 6 cycles of epirubicin 75 mg/m 2 plus docetaxel 75 mg/m 2 , resulting in overall and breast pCR rates of 15.9% and 18.6%, respectively [17].…”

Section: Discussionsupporting

confidence: 79%

Weekly taxane–anthracycline combination regimen versus tri-weekly anthracycline-based regimen for the treatment of locally advanced breast cancer: a randomized controlled trial

et al. 2017

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BackgroundExtensive studies have confirmed the efficacy of taxanes in combination with anthracycline-based chemotherapy on breast cancer. However, few studies have assessed the efficacy of weekly taxane–anthracycline regimens on locally advanced breast cancer. This study was to compare the efficacy and safety of a weekly taxane–anthracycline regimen with those of tri-weekly anthracycline-based regimen in patients with locally advanced breast cancer.MethodsPatients with locally advanced breast cancer were randomized to receive 4–6 cycles of neoadjuvant chemotherapy with tri-weekly 5-fluorouracil–epirubicin–cyclophosphamide (FEC) regimen or weekly paclitaxel–epirubicin (PE) regimen. The primary endpoint was the pathologic complete response (pCR) rate. Other endpoints included the clinical tumor response, breast-conserving surgery rate, and adverse events.ResultsBetween March 2010 and September 2013, 293 patients were randomized to the FEC (n = 151) and PE (n = 142) arms. The overall clinical response rate was significantly higher in the PE arm than in the FEC arm (76.06% vs. 59.95%, P = 0.001). Consistently, the post-chemotherapy pathologic T and N stages were significantly lower in the PE arm than in the FEC arm (P < 0.001). However, the pCR rate was similar in the two arms (10.61% vs. 12.31%, P = 0.665). Overall, 36 (27.27%) patients in the FEC arm and 6 (35.28%) in the PE arm were qualified for breast-conserving surgery. Most adverse events were comparable in both arms, with more severe neutropenia in the PE arm than in the FEC arm (11.97% vs. 5.96%, P = 0.031).ConclusionsIn patients with locally advanced breast cancer, weekly PE was not superior to FEC in terms of pCR. However, weekly PE has a higher response rate and superior down-staging effects. On this account, the PE regimen may be considered an alternative option for locally advanced breast cancer. Long-term follow-up data are needed to confirm the efficacy of this regimen on locally advanced breast cancer. Trial registration Chinese clinical trial registry, ChiCTR-TRC-10001043, September 21, 2014

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Section: Discussionsupporting

confidence: 79%

Weekly taxane–anthracycline combination regimen versus tri-weekly anthracycline-based regimen for the treatment of locally advanced breast cancer: a randomized controlled trial

et al. 2017

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“…[13,14,23,24] In combination with anthracyclines pCR rates of 10% to >20% are reported depending upon the stages of tumor included in that particular study. [17,[25][26][27][28][29] As most of the trials are retrospective, have small sample size and include a heterogeneous group of patients, it is not possible to directly compare the results but the pCR and cCR in our study are in accordance with results previously reported in the literature.…”

Section: Discussionsupporting

confidence: 77%

Clinical and pathological response rates of docetaxel-based neoadjuvant chemotherapy in locally advanced breast cancer and comparison with anthracycline-based chemotherapies: Eight-year experience from single centre

et al. 2011

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“…The pCR rate reported from these non-randomized trials ranges from 5 to 26%; however, the definition of pCR was not uniform across these studies [20][21][22][23][24][25][26][27][28].…”

Section: Anthracycline-taxane Combinationsmentioning

confidence: 99%

Neoadjuvant chemotherapy for “Triple Negative” breast cancer: a review of current practice and future outlook

Nahleh

2009

Med Oncol

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Patients with breast cancer who achieve a complete pathologic response (pCR) after preoperative (neoadjuvant) chemotherapy have an improved prognosis compared to those with residual disease; pCR being a good surrogate of long-term survival and cure from breast cancer. Despite their relative chemosensitivity, less than 25% of all patients with HER2/neu negative (0-2+), and hormone receptors (HR) negative tumors, so-called "Triple Negative" breast cancer (TNBC) treated with standard preoperative chemotherapy achieve pCR. Among patients with residual disease (no pCR) following neoadjuvant chemotherapy, patients with TNBC have the worst prognosis and overall survival. These patients lack the benefit of subsequent targeted therapy. Many studies have addressed improving the efficacy of neoadjuvant chemotherapy by including different cytotoxic agents, biologic modifiers, regimens, and schedules. Up to now, apart from trastuzumab for HRE2/neu+ tumors, none of the targeted agents can be considered a standard therapeutic option for primary systemic treatment. We hereby review the current literature on neoadjuvant chemotherapy for breast cancer, emphasizing treatment of TNBC. We also discuss potentially new therapeutic strategies that target this high risk group.

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Docetaxel and high-dose epirubicin as neoadjuvant chemotherapy in locally advanced breast cancer

Abstract: Docetaxel plus high-dose epirubicin showed promising activity in patients with locally advanced and inflammatory breast cancer, at the cost of moderate toxicity.

Cited by 22 publications

References 25 publications

Weekly taxane–anthracycline combination regimen versus tri-weekly anthracycline-based regimen for the treatment of locally advanced breast cancer: a randomized controlled trial

Weekly taxane–anthracycline combination regimen versus tri-weekly anthracycline-based regimen for the treatment of locally advanced breast cancer: a randomized controlled trial

Clinical and pathological response rates of docetaxel-based neoadjuvant chemotherapy in locally advanced breast cancer and comparison with anthracycline-based chemotherapies: Eight-year experience from single centre

Neoadjuvant chemotherapy for “Triple Negative” breast cancer: a review of current practice and future outlook

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