title: Vinorelbine, epirubicin, and methotrexate (VEM) as primary treatment in locally advanced breast cancer.
abstract: OBJECTIVE
  This phase II trial of VEM (vinorelbine + epirubicine + methotrexate) in the treatment of locally advanced breast cancer was conducted to obtain downstaging to allow surgery and breast conservation.
  
  
  METHODS
  This multicenter study recruited 58 patients with locally advanced breast cancer (two patients ineligible); 56 were evaluable for response and tolerance.
  
  
  RESULTS
  Downstaging was obtained in 77% of the patients with a pathological complete response (pCR) rate of 9%. At 33 months of follow-up, median survival has not been reached. Neutropenia grade 3-4 was reported in 31% of cycles with 3% of cycles with infection grade 3. Alopecia grade 3 was noticed for 71% of patients.
  
  
  CONCLUSIONS
  VEM represents an effective regimen for patients with locally advanced breast cancer, allowing an important pCR. Moreover, this regimen appears to be particularly well tolerated.
authors.affiliation: Thomayer Memorial Teaching Hospital, Praha, Czech Republic. jitka.abrahamova@ftn.cz
authors.forename: J
authors.initials: J
authors.lastname: Abrahamova
authors.forename: M
authors.initials: M
authors.lastname: Wagnerova
authors.forename: E
authors.initials: E
authors.lastname: Kubala
authors.forename: V
authors.initials: V
authors.lastname: Malec
authors.forename: E
authors.initials: E
authors.lastname: Simova
authors.forename: I
authors.initials: I
authors.lastname: Sirakova
authors.forename: E
authors.initials: E
authors.lastname: Pavlikova
authors.forename: D
authors.initials: D
authors.lastname: Machova
authors.forename: I
authors.initials: I
authors.lastname: Kocak
authors.forename: I
authors.initials: I
authors.lastname: Pavlikova
authors.forename: P
authors.initials: P
authors.lastname: Tuma
authors.forename: J
authors.initials: J
authors.lastname: Prausova
authors.forename: D
authors.initials: D
authors.lastname: Kroslakova
authors.forename: I
authors.initials: I
authors.lastname: Van Praagh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008408:Mastectomy; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009503:Neutropenia / Q000139:chemically induced; D015996:Survival Rate; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives; D000077235:Vinorelbine
chemical_list: D015251:Epirubicin; D014747:Vinblastine; D000077235:Vinorelbine; D008727:Methotrexate