title: Primary therapy with ECF in combination with a GnRH analog in premenopausal women with hormone receptor-positive T2-T4 breast cancer.
abstract: Patients with hormone receptor-positive tumors less often show a pathological complete response (pCR) than do those with hormone receptor-negative tumors. The addition of endocrine therapies may improve the clinical benefits of primary therapies in these patients. We investigated the efficacy of the epirubicin+cisplatin+fluorouracil (ECF) as continuous infusion) regimen in association with a gonadotropin-releasing hormone (GnRH) analog in 36 premenopausal women with T2-T4a-d N0-2 M0 ER and/or PgR-positive breast cancer. Median age was 39.5 years (range 26-53). Clinical response (complete or partial) was observed in 27 out of 36 patients (75% 95% CI 57.8-87.9%) and a pCR was observed in four patients (11%). Nine (25%) patients had stable disease and no progression was observed. Twenty-one patients (58%) were submitted for breast-conserving surgery and 15 had a radical mastectomy. No baseline clinical and biological characteristics significantly correlated with response. Thirty out of 31 patients evaluable for endocrine assessment had documented ovarian suppression, which occurred after a median of 28 days (range 20-43). We conclude that the combination of ECF and a GnRH analog is associated with a high response rate in the primary treatment of breast cancer. Further studies combining chemotherapy and endocrine agents are warranted in patients with hormone receptor-positive tumors.
authors.affiliation: Research Unit of Medical Senology, Department of Medicine, European Institute of Oncology, via Ripamonti 435, 20141 Milan, Italy. rosalba.torrisi@ieo.it
authors.forename: Rosalba
authors.initials: R
authors.lastname: Torrisi
authors.forename: Marco
authors.initials: M
authors.lastname: Colleoni
authors.forename: Paolo
authors.initials: P
authors.lastname: Veronesi
authors.forename: Andrea
authors.initials: A
authors.lastname: Rocca
authors.forename: Giulia
authors.initials: G
authors.lastname: Peruzzotti
authors.forename: Gianluca
authors.initials: G
authors.lastname: Severi
authors.forename: Marta
authors.initials: M
authors.lastname: Medici
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Renne
authors.forename: Mattia
authors.initials: M
authors.lastname: Intra
authors.forename: Alberto
authors.initials: A
authors.lastname: Luini
authors.forename: Franco
authors.initials: F
authors.lastname: Nolè
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Viale
authors.forename: Aron
authors.initials: A
authors.lastname: Goldhirsch
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality; D002945:Cisplatin / Q000008:administration & dosage; D018450:Disease Progression; D004359:Drug Therapy, Combination; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006801:Humans; D008875:Middle Aged; D010053:Ovary / Q000187:drug effects; D017697:Premenopause; D016896:Treatment Outcome
chemical_list: D007987:Gonadotropin-Releasing Hormone; D015251:Epirubicin; D002945:Cisplatin; D005472:Fluorouracil