Randomized phase III trial of adjuvant epirubicin followed by cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) versus CMF followed by epirubicin in patients with node-negative or 1–3 node-positive rapidly proliferating breast cancer

Amadori, Dino; Silvestrini, Rosella; Lena, M. De; Boccardo, Francesco; Rocca, Andrea; Scarpi, Emanuela; Schittulli, F.; Brandi, Mario; Maltoni, Roberta; Serra, Patrizia; Ponzone, Riccardo; Biglia, Nicoletta; Giannì, L.; Tienghi, A.; Valerio, Maria Rosaria; Bonginelli, P.; Amaducci, Laura; Faedi, Marina; Baldini, Editta; Paradiso, Angelo

doi:10.1007/s10549-010-1257-5

Cited by 19 publications

(13 citation statements)

References 25 publications

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“…comorbidities) might be considered as prognostic factors implicated in the results observed. However, our analysis examined a population enrolled in a clinical trial with inclusion and exclusion criteria [9] that may have reduced the impact of this bias.…”

Section: Discussionmentioning

confidence: 99%

“…This study was a secondary analysis of a prospective, randomised, multicentre, open label phase III trial comparing the efficacy of three treatment arms in patients with rapidly proliferating EBC, that had previously been reported [9,10]. The study was approved by the institutional review boards of each participating centre and has been registered as a National Cancer Institute trial (NCT01031030).…”

Section: Study Populationmentioning

confidence: 99%

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Time to initiation of adjuvant chemotherapy in patients with rapidly proliferating early breast cancer

Farolfi

Scarpi

Rocca

et al. 2015

European Journal of Cancer

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Section: Discussionmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

Time to initiation of adjuvant chemotherapy in patients with rapidly proliferating early breast cancer

Farolfi

Scarpi

Rocca

et al. 2015

European Journal of Cancer

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“…All patients underwent surgery at the NCRC Istituto Tumori ‘Giovanni Paolo II' of Bari between 1998 and 2004 and were enrolled into a prospective multicenter clinical study. 30 Patients were eligible if: they were females ≤70 years of age; had histological diagnosis of invasive breast carcinomas of any size with one- to three-positive axillary nodes or node-negative tumors >1 cm; had radical tumor resection; had no evidence of metastatic disease. Patients were excluded if they had a previous history of invasive breast cancer, or other previous or concomitant malignancies or concomitant diseases.…”

Section: Methodsmentioning

confidence: 99%

Nuclear NHERF1 expression as a prognostic marker in breast cancer

et al. 2013

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Our purpose was to investigate whether Na+/H+ exchanger regulatory factor 1 (NHERF1) expression could be linked to prognosis in invasive breast carcinomas. NHERF1, an ezrin-radixin-moesin (ERM) binding phosphoprotein 50, is involved in the linkage of integral membrane proteins to the cytoskeleton. It is therefore believed to have an important role in cell signaling associated with changes in cell cytoarchitecture. NHERF1 expression is observed in various types of cancer and is related to tumor aggressiveness. To date the most extensive analyses of the influence of NHERF1 in cancer development have been performed on breast cancer. However, the underlying mechanism and its prognostic significance are still undefined. NHERF1 expression was studied by immunohistochemistry (IHC) in a cohort of 222 breast carcinoma patients. Association of cytoplasmic and nuclear NHERF1 expression with survival was analyzed. Disease-free survival (DFS) and overall survival (OS) were determined based on the Kaplan–Meier method. Cytoplasmic NHERF1 expression was associated with negative progesterone receptor (PgR) (P=0.017) and positive HER2 expression (P=0.023). NHERF1 also showed a nuclear localization and this correlated with small tumor size (P=0.026) and positive estrogen receptor (ER) expression (P=0.010). Multivariate analysis identified large tumor size (P=0.011) and nuclear NHERF1 expression (P=0.049) to be independent prognostic variables for DFS. Moreover, the nuclear NHERF1(−)/ER(−) immunophenotype (27%) was statistically associated with large tumor size (P=0.0276), high histological grade (P=0.0411), PgR-negative tumors (P<0.0001) and high proliferative activity (P=0.0027). These patients had worse DFS compared with patients with nuclear NHERF1(+)/ER(+) tumors (75.4% versus 92.6% P=0.010). These results show that the loss of nuclear NHERF1 expression is associated with reduced survival, and the link between nuclear NHERF1 and ER expression may serve as a prognostic marker for the routine clinical management of breast cancer patients.

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“…However, adding taxane to epirubicin did not increase the risk of amenorrhea in other studies [14], [15]. Epirubicin was widely used in adjuvant chemotherapy for early breast cancer patients [16]–[18]. The CIA rate with epirubicin and taxane based chemotherapy is not well known.…”

Section: Introductionmentioning

confidence: 91%

The Risk of Amenorrhea Is Related to Chemotherapy-Induced Leucopenia in Breast Cancer Patients Receiving Epirubicin and Taxane Based Chemotherapy

Zhou¹,

Ding²,

Liang³

et al. 2012

PLoS ONE

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BackgroundChemotherapy-induced amenorrhea (CIA) is common in young breast cancer patients. The incidence of CIA associated with regimens involving epirubicin and taxane was not well known. Furthermore, previous studies suggested leucopenia and amenorrhea may reflect inter-individual variations in pharmacokinetics. The purpose of this study was to investigate the association between leucopenia after first cycle of chemotherapy and CIA in young breast cancer patients receiving epirubicin and taxane based chemotherapy. Furthermore, the incidence of CIA was also assessed.Methodology and Principal FindingsBetween October 2008 and March 2010, 186 consecutive premenopausal patients, treated with epirubicin and taxane based chemotherapy, were recruited. Information about CIA was collected by telephone and out-patient clinic. Of these 186 patients, data from 165 patients were included and analyzed. Of all 165 patients, CIA occurred in 72 patients (43.64%). In multivariate analysis, age older than 40 y (OR: 16.10, 95% CI: 6.34–40.88, P<0.001) and previous childbearing (OR: 3.17, 95% CI: 1.06–9.47, P = 0.038) were significantly associated with probability of CIA. Compared to patients treated without taxane, patients treated with taxane-contained regimens did not have a significantly higher rate of CIA (P>0.05). The rate of CIA in leucopenia group (52.56%) was significantly higher than that in normal leukocyte group (34.62%) (P = 0.024). In patients treated with a FEC regimen (cyclophosphamide, epirubicin and 5-fluorouracil), the rate of CIA in leucopenia group (59.57%) was significantly higher than that in normal leukocyte group (36.84%) (P = 0.037).ConclusionsAge at diagnosis and previous childbearing were both found to significantly increase the risk of CIA, whereas additional taxane was not associated with increased rate of CIA. Importantly, leucopenia after first cycle of chemotherapy was associated with increased risk of CIA, which suggested that leucopenia may be an early predictor of chemotherapy-induced infertility.

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Randomized phase III trial of adjuvant epirubicin followed by cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) versus CMF followed by epirubicin in patients with node-negative or 1–3 node-positive rapidly proliferating breast cancer

Cited by 19 publications

References 25 publications

Time to initiation of adjuvant chemotherapy in patients with rapidly proliferating early breast cancer

Time to initiation of adjuvant chemotherapy in patients with rapidly proliferating early breast cancer

Nuclear NHERF1 expression as a prognostic marker in breast cancer

The Risk of Amenorrhea Is Related to Chemotherapy-Induced Leucopenia in Breast Cancer Patients Receiving Epirubicin and Taxane Based Chemotherapy

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