Neoadjuvant chemotherapy of breast cancer with pirarubicin versus epirubicin in combination with cyclophosphamide and docetaxel

Abstract

Breast cancers (BC) are treated with surgery, radiotherapy, and chemotherapy. Neoadjuvant chemotherapy (NACT) is an emerging treatment option in many cancers and is given before primary therapy to shrink tumor size. The efficacy of NACT in varied settings of BC, such as inoperable tumors, borderline resectable tumors, and breast-conserving surgery, has been debated extensively in literature, and the results remain unclear and depended on a wide variety of factors such as cancer type, disease extent, and the specific combination of chemotherapy drugs. This study was performed to examine the efficacy, toxicity, and tolerability of pirarubicin (THP) and epirubicin (EPI) in combination with docetaxel and cyclophosphamide in a NACT setting for BC. A total of 48 patients with stage II or III breast cancers were randomly divided into two groups: THP group and EPI group. The patients in THP group received 2-4 cycles of neoadjuvant chemotherapy with DTC regimen (docetaxel, THP, cyclophosphamide), while patients in the EPI group received 2-4 cycles of DEC regimen (docetaxel, EPI, cyclophosphamide) before surgery. The incidence of adverse reactions and the efficacy of the treatment regimen were compared between the two groups. Prognostic evaluation indexes were estimated by Kaplan-Meier survival analysis, including the 5-year disease-free survival (DFS) and overall survival (OS). The overall response rate in THP group was 83.3 %, and the EPI group showed a response rate of 79.2 %, with no statistically significant difference in response rate between the two groups. The incidence of cardiac toxicity, myelosuppression, nausea, and vomiting in the THP group was significantly lower than the EPI group (all P < 0.05). The incidence of hepatic toxicity, alopecia, and diarrhea in the THP group was also lower than the EPI group, but these differences were not statistically significant. The 5-year DFS and OS in THP versus EPI groups were 80 versus 76 % (DFS) and 86 versus 81 % (OS), respectively. Our study found that NACT with DTC regimen and DEC regimen were both very effective in treatment of BC. However, THP-based combination therapy was associated with significantly lower incidence of cardiac toxicity, myelosuppression, nausea, and vomiting.

Targeting the MIR34C-5p-ATG4B-autophagy axis enhances the sensitivity of cervical cancer cells to pirarubicin

“…1 Studies have also confirmed the effectiveness of THP in bladder cancer, 2 ovarian cancer 3 and breast cancer 4 in vitro. Due to a favorable antitumor efficiency with limited side effect, the potential application of THP in solid tumors has aroused great interest for researchers.…”

Inhibition of miR-15a-5p Promotes the Chemoresistance to Pirarubicin in Hepatocellular Carcinoma via Targeting eIF4E

“…Pirarubicin (THP) is a new generation of anthracycline antitumor drugs, which is a derivative of doxorubicin, and is widely used as a first-line drug in the treatment of hematological malignancies [ 9 ]. In recent years, studies have shown that THP has a wide antitumor spectrum and can also be used in the treatment of breast cancer, bladder cancer, ovarian cancer, and other solid tumors [ 10 – 12 ]. At the same time, animal experiments have shown that THP has little effect on the reproductive system [ 9 ].…”

Development of a Selective Tumor-Targeted Drug Delivery System: Hydroxypropyl-Acrylamide Polymer-Conjugated Pirarubicin (P-THP) for Pediatric Solid Tumors

“…An example is 4 -O-tetrahydropyranyldoxorubicin or pirarubicin, a derivative of doxorubicin commercially available in the EU, Japan, and other Asian nations [37]. Pirarubicin is less cardiotoxic than doxorubicin [38], has an efficacy profile comparable to that of doxorubicin, and has demonstrated efficacy against ovarian cancer [39], breast cancer [40], and pediatric tumors, such as neuroblastoma [41,42], hepatoblastoma [43], and rhabdomyosarcoma [44].…”