Neo-Adjuvant chemotherapy in 101 non inflammatory breast cancers : treatment results

Belembaogo, E.; Vernis, Miguel Moreno; Chollet, P.; Curé, Hervé; Verrelle, Pierre; Kauffmann, P.; Jl, Achard; Bouëdec, G. Le; Feillel, V.; Chassagne, J; Bignon, Y. J.; Latour, M. De; Lafaye, C.; Dauplat, J.; Plagne, R

doi:10.1007/978-2-8178-0782-9_38

Cited by 3 publications

(3 citation statements)

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“…In this study, the favourable results were ascribed to the continuous exposure to 5FU and to the possible synergy between cisplatin and 5FU. In general, following primary chemotherapy response rates of 57-96% have been reported (Valagussa et al, 1990;Chevallier et al, 1993;Bonadonna et al, 1990;Belembaogo et al, 1992;Calais et al, 1994;Touboul et al, 1992;Mauriac et al, 1991;Perloff et al, 1988).…”

Section: Discussionmentioning

confidence: 97%

“…In practice, preoperative chemotherapy has been employed in attempts to reduce the size of large but resectable breast cancers in order to allow breast conservation (Bonadonna et al, 1990;Belembaogo et al, 1992;Calais et al, 1994;Touboul et al, 1992;Mauriac et al, 1991;Perloff et al, 1988). The majority of the preoperative chemotherapeutic regimens contain standard doses of cyclophosphamide, 5-fluorouracil and either methotrexate or an anthracyclin.…”

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confidence: 99%

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Efficacy of up-front 5-fluorouracil – epidoxorubicin – cyclophosphamide (FEC) chemotherapy with an increased dose of epidoxorubicin in high-risk breast cancer patients

Wall

Rutgers²,

Holtkamp³

et al. 1996

Br J Cancer

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Summary The prognosis of patients with stage IIIB breast carcinoma with tumour spread to the apical axillary lymph nodes has hardly improved despite adequate locoregional control and the introduction of systemic adjuvant therapy. A combined modality regimen that includes anthracyclin-based chemotherapy, highdose chemotherapy with peripheral stem cell support and radiation and hormonal therapy is currently under investigation in this subset of patients. The present study aims to document the efficacy and feasibility of doseintensive epidoxorubicin in combination with a standard dose of 5-fluorouracil and cyclophosphamide as upfront chemotherapy in this setting. A preoperative chemotherapy regimen consisting of three courses of 5-fluorouracil 500 mg m-2, epidoxorubicin 120 mg m -2 and cyclophosphamide 500 mg m-2 (FE,20C) was administered at 21 day intervals without haematopoietic growth factors to 70 patients with apex node-positive disease. All patients were below 60 years of age and had not had prior chemotherapy or radiotherapy. Sixty-six patients were evaluable for clinical response and histopathological examination could be performed in 62 of these. Thirteen al., 1992;Rubens, 1978). When a radical mastectomy is performed, a local regional recurrence rate of 46% is reported (van Dongen, 1977). The vast majority of breast cancer patients with apex node-positive disease die from metastatic disease, indicating that occult systemic metastases must have been present at the time of first presentation. In view of these data it has been our policy to precede a planned mastectomy with an apical axillary lymph node biopsy (van Dongen, 1977). When tumour involvement of the lymph node is observed on frozen section, surgery is cancelled and the patient is scheduled for locoregional radiation therapy. Additional systemic treatment in patients with apex node-positive disease has been shown to be of no benefit. In a three-armed study that we published previously (Schaake-Koning et al., 1985), radiotherapy alone (1) was compared with (2) radiotherapy followed by 12 courses of cyclophosphamide, methotrexate and 5-fluorouracil (CMF) and with (3) radiotherapy preceded and followed by chemotherapy consisting of CMF alternated by doxorCorrespondence: E van der Wall,

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Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 99%

Efficacy of up-front 5-fluorouracil – epidoxorubicin – cyclophosphamide (FEC) chemotherapy with an increased dose of epidoxorubicin in high-risk breast cancer patients

Wall

Rutgers²,

Holtkamp³

et al. 1996

Br J Cancer

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“…Since 1990 several reports have shown the effectiveness of primary chemotherapy in breast conservative surgery of resectable tumours larger than 3 cm (Bonnadonna et al, 1990;Gazet et al, 1991;Mauriac et al, 1991;Belembaogo et al, 1992;Calais et al, 1994;Smith et al, 1995). This new therapeutic strategy, as well as those used in locally advanced breast disease, requires the validation of clinical and biological factors capable of predicting the tumoral response to cytotoxic therapy, and the subsequent clinical outcome.…”

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confidence: 99%

Primary chemotherapy in breast invasive carcinoma: predictive value of the immunohistochemical detection of hormonal receptors, p53, c-erbB-2, MiB1, pS2 and GST pi

MacGrogan

Mauriac²,

Durand³

et al. 1996

Br J Cancer

168

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Summary Primary chemotherapy in operable breast invasive carcinoma enables tumour reduction and conservative surgery. In order to search for one or more biological factors capable of predicting tumour behaviour under primary chemotherapy, and subsequent patient survival, an immunohistochemical study was performed with specific antibodies to p53, c-erbB-2 (Her-2/neu), Mibl (antiKi-67), pS2, GSTir, oestrogen receptors (ERs) and progesterone receptors (PRs). Core biopsies, obtained before primary chemotherapy, were available from a series of 128 breast invasive carcinomas treated between January 1985 and April 1989, with a median follow-up of 93.3 months. Univariate statistical analysis showed that negative ER detection by immunohistochemistry (IHC) was highly correlated with chemosensitivity (P=0.001). A high percentage of Mibl-positive tumour cells (>40%), as well as initial tumour size less than 4 cm, were also correlated with tumour responsiveness to chemotherapy (P=0.009 and P=0.03). By multivariate analysis IHC-ER, Mibl and initial tumour size were independent predictors, the last parameter being the most important. Concerning subsequent patient survival, c-erbB-2 overexpression, as detected by IHC, was significant with respect to overall survival (OS) (P=0.0006), disease-free interval (DFI) (P=0.03) and metastasis-free interval (MFI) (P=0.008) by univariate analysis. Furthermore, c-erbB-2 was the major independent prognostic factor for OS and MFI by multivariate analysis.

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Neo-Adjuvant chemotherapy in breast cancer Study of 477 evaluable patients with primary breast cancers treated between 1980 and 1992

Weil

Auclerc

Borel

et al. 1994

Cancer Treatment an Update

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Neo-Adjuvant chemotherapy in 101 non inflammatory breast cancers : treatment results

Cited by 3 publications

References 1 publication

Efficacy of up-front 5-fluorouracil – epidoxorubicin – cyclophosphamide (FEC) chemotherapy with an increased dose of epidoxorubicin in high-risk breast cancer patients

Efficacy of up-front 5-fluorouracil – epidoxorubicin – cyclophosphamide (FEC) chemotherapy with an increased dose of epidoxorubicin in high-risk breast cancer patients

Primary chemotherapy in breast invasive carcinoma: predictive value of the immunohistochemical detection of hormonal receptors, p53, c-erbB-2, MiB1, pS2 and GST pi

Neo-Adjuvant chemotherapy in breast cancer Study of 477 evaluable patients with primary breast cancers treated between 1980 and 1992

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