Neoadjuvant versus adjuvant chemotherapy in premenopausal patients with tumours considered too large for breast conserving surgery: Preliminary results of a randomised trial: S6

Scholl, Susy; Fourquet, A.; Asselain, Bernard; Pierga, Jean‐Yves; Vilcoq, J.R.; Durand, Jean‐Claude; Dorval, Thierry; Palangié, T; Jouve, M; Beuzeboc, Philippe; Garcio-Giralt, E.; Salmon, Rémy; Rochefordière, Anne de la; Campana, F.; Pouillart, P

doi:10.1016/0959-8049(94)90537-1

Cited by 396 publications

(187 citation statements)

References 25 publications

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“…Preoperative administration of systemic therapy might theoretically improve survival. Since this study was commenced, three randomized trials comparing pre-and post-operative chemotherapy have reported survival data: one study found an initial clear X2 4.690,P'< 0.05 survival advantage, later lost, for preoperative systemic therapy (Scholl et al, 1994(Scholl et al, , 1995; another study reported only a diseasefree survival advantage for the preoperatively treated group (Semiglazov et al, 1994); and the third study did find a survival advantage, but 23% of those in the control arn received no systemic adjuvant therapy and these patients constituted 10% of the relapses (Mauriac et al, 1991). Comparison of our data with historical controls of post-operative adjuvant chemotherapy is unreliable but does not suggest that the women have fared worse than patients treated either with (Morrison et al, 1989;Tormey et al, 1992) or without a doxorubicin based regimen (Fisher et al, 1969).…”

Section: Response To Primary Hormone Therapymentioning

confidence: 99%

Primary systemic therapy for operable breast cancer - 10-year survival data after chemotherapy and hormone therapy

Cameron

Anderson²,

Levack³

et al. 1997

Br J Cancer

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Summary Between 1984 and 1990, 94 women presenting to the Edinburgh Breast Unit with operable breast cancer of 4 cm or greater in diameter (T2, T3, NO, Ni, MO) were given preoperative systemic therapy. Initially, all women received hormone therapy, with CHOP (cyclophosphamide 1 g m-2, doxorubicin 50 mg m-2, vincristine 1.4 mg m-2 to a maximum of 2 mg and prednisolone 40 mg per day orally for 5 days) chemotherapy being administered to those who failed to respond by 3 months. After April 1987, first-line hormone therapy was only offered to women with oestrogen receptor (ER)-moderate/-rich (> 20 fmol mg-1 protein) tumours, and CHOP was reserved for those women whose tumours failed to respond to hormone therapy and for those with ER-negative/-poor tumours. Response data have been published previously (Anderson et al, 1991). After a median follow-up of 7.5 years, there is no difference in survival between those women given initial hormone therapy and those given chemotherapy, with neither group having yet reached its median survival. The two key factors that predicted for a poor survival were the number of involved axillary nodes after preoperative systemic therapy (P < 0.00001) and a lack of response to preoperative therapy (P < 0.05). These data suggest that many women with ER-moderate/-rich tumours will have a good prognosis after preoperative hormone therapy alone. However, it is possible to identify, by their post-systemic therapy axillary node status, a group of women who still have an appalling prognosis after preoperative chemotherapy or hormone therapy.

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Section: Response To Primary Hormone Therapymentioning

confidence: 99%

Primary systemic therapy for operable breast cancer - 10-year survival data after chemotherapy and hormone therapy

Cameron

Anderson²,

Levack³

et al. 1997

Br J Cancer

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“…It should, however, be noted that in this series, patients treated with exclusive or preoperative radiotherapy fared worse in terms of locoregional control than others, perhaps also because of a selection of patients with poor prognosis. This opens the debate as to whether radiotherapy could not play a role in increasing the rate of breast-conserving treatments for some invasive carcinomas, as it is an important part of the treatment of large breast cancers (Whelan et al, 2000;Clarke et al, 2005) and has been shown to achieve complete clinical response (6 -41%) with doses compatible with planned secondary surgeries (Calitchi et al, 1991;Scholl et al, 1994;Broet et al, 1999;Bollet et al, 2006). At the Institut Curie, the S6 trial randomised premenopausal women between chemotherapy and radiotherapy as an initial treatment for large breast cancers (Scholl et al, 1994).…”

Section: Discussionmentioning

confidence: 99%

High rates of breast conservation for large ductal and lobular invasive carcinomas combining multimodality strategies

et al. 2008

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The literature reports low rates of breast conservation after neoadjuvant chemotherapy for operable breast cancers not amenable to initial breast-conserving surgery. This study aims to compare the outcome of lobular vs ductal carcinomas after neoadjuvant chemotherapy. Between 1989 and 1999, 750 patients with clinical stage II/IIIA ductal (672) or lobular (78) invasive breast carcinomas were treated at the Institut Curie with primary anthracycline-based polychemotherapy followed by either breast conservation (surgery and/or radiotherapy) or mastectomy. Median follow-up was 10 years. Clinical response to primary chemotherapy was significantly worse for lobular than for ductal carcinomas (47 vs 60%; P ¼ 0.04), but only histological grade remained predictive in multivariate analysis. Breast conservation was high for both ductal and lobular carcinomas (65 and 54%; P ¼ 0.07), due, in part, to the use of radiotherapy, either exclusive or preoperative, for respectively 26 and 40% of patients. The lobular type had no adverse effect, neither on locoregional control nor on overall survival, even in the group of patients treated with breast conservation.

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“…The so-called 'S6-trial' (Scholl et al, 1994) was conducted to assess whether primary chemotherapy improved survival, as compared to the same chemotherapy scheduled to follow the local regional treatment (adjuvant chemotherapy). Premenopausal breast cancer patients were included between October 1986 and June 1990, and randomized to receive either primary or adjuvant chemotherapy.…”

Section: Primary Chemotherapy Trialmentioning

confidence: 99%

“…In what follows, we focus on the recurrence-free interval and not on the overall survival which was considered in a previous paper (Scholl et al, 1994). The recurrence-free interval is defined as the time from randomization until progression on the first observation of tumor recurrence (local, regional, distant).…”

Section: Primary Chemotherapy Trialmentioning

confidence: 99%

Two-Sample Statistics for Testing the Equality of Survival Functions Against Improper Semi-parametric Accelerated Failure Time Alternatives: An Application to the Analysis of a Breast Cancer Clinical Trial

et al. 2004

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This paper presents two-sample statistics suited for testing equality of survival functions against improper semi-parametric accelerated failure time alternatives. These tests are designed for comparing either the short-or the long-term effect of a prognostic factor, or both. These statistics are obtained as partial likelihood score statistics from a time-dependent Cox model. As a consequence, the proposed tests can be very easily implemented using widely available software. A breast cancer clinical trial is presented as an example to demonstrate the utility of the proposed tests.

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Neoadjuvant versus adjuvant chemotherapy in premenopausal patients with tumours considered too large for breast conserving surgery: Preliminary results of a randomised trial: S6

Cited by 396 publications

References 25 publications

Primary systemic therapy for operable breast cancer - 10-year survival data after chemotherapy and hormone therapy

Primary systemic therapy for operable breast cancer - 10-year survival data after chemotherapy and hormone therapy

High rates of breast conservation for large ductal and lobular invasive carcinomas combining multimodality strategies

Two-Sample Statistics for Testing the Equality of Survival Functions Against Improper Semi-parametric Accelerated Failure Time Alternatives: An Application to the Analysis of a Breast Cancer Clinical Trial

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