title: Primary chemotherapy with gemcitabine, epirubicin and taxol (GET) in operable breast cancer: a phase II study.
abstract: This trial was conducted to assess the activity and tolerability of the gemcitabine, epirubicin, taxol triplet combination in patients with operable breast cancer. After core biopsy, 43 women with stage II-IIIA breast cancer were treated with gemcitabine 1000 mg m(-2) over 30 min on days 1 and 4, epirubicin 90 mg m(-2) as an intravenous bolus on day 1, and taxol 175 mg m(-2) as a 3-h infusion on day 1, every 21 days for four cycles. The primary end point was the percentage of pathological complete responses (pCR) in the breast; secondary end points were tolerability, clinical response rates, overall and progression-free survival, tumour biomarkers before and after primary chemotherapy (PCT). All patients were included in safety and survival analyses; 41 eligible patients were evaluated for response. The overall clinical response rate was 87.8% (95% CI 77.8-97.8), with 26.8% complete responses (95% CI 13.3-40.3). A pCR in the breast was observed in six patients (14.6%; 95% CI 3.8-25.4); 15 patients (36.6%; 95% CI 21.9-51.3) had negative axillary lymph nodes. Grade 4 neutropenia was observed in 67.4% of the patients; febrile neutropenia occurred in 1.9% of cycles (granulocyte colony-stimulating factor was used in 3.2% of the cycles to shorten the duration of neutropenia). A statistically significant difference between Mib-1 at baseline (> or =20% in 71.4% of the patients) and at definitive surgery (28.6%, P < 0.05) was observed. The gemcitabine, epirubicin, taxol regimen is active and well tolerated as PCT for operable breast cancer. This combination allows the administration of full doses of active agents with a low incidence of febrile neutropenia.
authors.affiliation: Department of Medical Oncology and Hematology, University of Modena and Reggio Emilia, Italy. conte.pierfranco@unimore.it
authors.forename: P F
authors.initials: PF
authors.lastname: Conte
authors.forename: S
authors.initials: S
authors.lastname: Donati
authors.forename: A
authors.initials: A
authors.lastname: Gennari
authors.forename: V
authors.initials: V
authors.lastname: Guarneri
authors.forename: C
authors.initials: C
authors.lastname: Orlandini
authors.forename: M
authors.initials: M
authors.lastname: Rondini
authors.forename: M
authors.initials: M
authors.lastname: Roncella
authors.forename: L
authors.initials: L
authors.lastname: Marini
authors.forename: P
authors.initials: P
authors.lastname: Collecchi
authors.forename: P
authors.initials: P
authors.lastname: Viacava
authors.forename: A G
authors.initials: AG
authors.lastname: Naccarato
authors.forename: R
authors.initials: R
authors.lastname: Degli Esposti
authors.forename: S
authors.initials: S
authors.lastname: Bonardi
authors.forename: A
authors.initials: A
authors.lastname: Bottini
authors.forename: S
authors.initials: S
authors.lastname: Saracchini
authors.forename: S
authors.initials: S
authors.lastname: Tumolo
authors.forename: G
authors.initials: G
authors.lastname: Gullo
authors.forename: A
authors.initials: A
authors.lastname: Santoro
authors.forename: L
authors.initials: L
authors.lastname: Crino
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000601:surgery; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008875:Middle Aged; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D043823:Taxoids; D003841:Deoxycytidine; D015251:Epirubicin