title: Efficacy of a primary chemotherapy regimen combining vinorelbine, epirubicin, and methotrexate (VEM) as neoadjuvant treatment in 89 patients with operable breast cancer.
abstract: OBJECTIVE
  In order to improve the breast conservation rate for noninflammatory operable breast cancer stage II and IIIa, neoadjuvant chemotherapy containing vinorelbine, 25 mg/m(2), epirubicin, 35 mg/m(2), and methotrexate, 20 mg/m(2), VEM, was administered days 1 and 8 every 28 days for six cycles.
  
  
  METHODS
  From October, 1991 to April, 1996, 89 patients (median age 52 years, range 31-72; 68 stage II and 19 stage IIIa) received 519 cycles (median six) of VEM chemotherapy.
  
  
  RESULTS
  Hematotoxicity was mild (World Health Organization grade 3-4 neutropenia in 28% of cycles for 22 patients, and anemia or thrombocytopenia >grade 2) when it occurred, and there were no toxic deaths. The clinical objective response was 90% (28% complete response and 62% partial response). All patients underwent surgery: 77 (87%) had conservative and 12 (13%) had modified radical mastectomy, and 12 (14%) reached pathological complete response. At December, 2000, with a median follow-up of 86 months (39-100), 13 patients had relapsed, and five had died of metastatic disease. Median disease-free survival was 100 months (8.4 years) and median survival had not yet been reached.
authors.affiliation: Centre Jean Perrin and INSERM U 71, Clermont-Ferrand, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Van Praagh
authors.forename: Hervé
authors.initials: H
authors.lastname: Cure
authors.forename: Bernard
authors.initials: B
authors.lastname: Leduc
authors.forename: Sabine
authors.initials: S
authors.lastname: Charrier
authors.forename: Guillaume
authors.initials: G
authors.lastname: Le Bouedec
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Achard
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Ferriere
authors.forename: Viviane
authors.initials: V
authors.lastname: Feillel
authors.forename: Monique
authors.initials: M
authors.lastname: De Latour
authors.forename: Jacques
authors.initials: J
authors.lastname: Dauplat
authors.forename: Philippe
authors.initials: P
authors.lastname: Chollet
mesh_terms: 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; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; 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; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000077235:Vinorelbine
chemical_list: D015251:Epirubicin; D014747:Vinblastine; D000077235:Vinorelbine; D008727:Methotrexate