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2019, Number 1

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Cir Cir 2019; 87 (1)

Neoadjuvant epirubicin with or without sequential docetaxel in treatment of advanced breast cancer: assessment of pathological complete response and chemotherapy tolerability

Ramírez-Torres N, Pérez-Puentes A, Moctezuma-Meza C, Victoria-Ayala R, Ortiz-Rodríguez K, Valenzuela-Martínez LA, Ayala-Anzures ME

Language: Spanish
References: 33
Page: 59-68
PDF size: 963.69 Kb.


ABSTRACT

Objective: To assess the pathological complete response (pCR) rate after neoadjuvant chemotherapy (NC) with anthracyclines with or without taxanes in management of locally advanced breast cancer (LABC). Method: Patients with LABC were included. A cohort received four cycles of 5-fluorouracil [FEC] (FEC 500 mg/m2, epirubicin 75 mg/m2, cyclophosphamide 500 mg/m2) every 3 weeks followed by four cycles of docetaxel (D) 75 mg/m2 as 1 h infusion intravenous every 3 weeks. Another cohort received six cycles of FE100C (500, 100 and 600 mg/m2). The chemotherapy was followed by surgery and radiotherapy. Results: There was no statistically significant difference in overall response rate (ORR) (ORR: 78.5 vs. 85%; p = 0.299) and clinical complete response (cCR) (cCR: 20.6 vs. 33.3%; p = 0.103) for 4FEC→4D compared to 6FE100C, respectively. Instead, there was a statistically significant improved rate of pCR (30.2 vs. 16.7%; p = 0.049) and negative axillary lymph nodes (51.6 vs. 35%; p = 0.03) for 4FEC→4D compared to 6FE100C, respectively. Serious toxicity was low and non-significant in both cohorts. The logistic regression multivariate models showed that main significant predictors to obtain a pCR were 4FEC→4D NC (odds ratio [OR]: 2.7; p = 0.019) and stage IIIA (OR: 3.8; p = 0.002). Conclusion: This study showed that 4FEC→4D regimen with conventional dose is highly active and well tolerated in patients with LABC in our hospital.


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