[Clinical comparison of GC regimen (gemcitabine and cisplatin) versus FEC regimen (fluorouracil, epirubicin, and cyclophosphamide) as neoadjuvant chemotherapy for breast cancer].
OBJECTIVE
Neoadjuvant chemotherapy plays a crucial role in treating breast cancer, but there is no standard regimen. Recently, FEC regimen [5-fluorouracil (5-FU), epirubicin (EPI), plus cyclophosphamide (CTX)] is the most commonly used; gemcitabine (GEM) is also a new active antimetabolite for breast cancer, however, the experience with neoadjuvant gemcitabine is limited. This study was to compare the efficacy of GC regimen and FEC regimen on breast cancer, and observe the adverse events.


METHODS
From Mar. 2003 to Sep. 2005, 62 patients with stage II-III breast cancer were treated with 2 cycles of either GC regimen or FEC regimen before operation. The 22 patients in GC group received GEM (1000 mg/m(2)) by intravenous injection on Day 1 and Day 8, and DDP (75 mg/m(2)) by intravenous injection on Day 2. The 40 patients in FEC group received EPI (50 mg/m(2)) by intravenous injection on Day 1, CTX (500 mg/m(2)) by intravenous injection on Day 1 and Day 8, and 5-FU (500 mg/m(2)) by 4-hour continuous infusion on Day 1 and Day 8. Clinical response and adverse events were assessed after neoadjuvant chemotherapy.


RESULTS
The overall response rate (RR) was 63.6% in GC group and 72.5% in FEC group. After GC therapy, 4 patients showed clinical complete remission (cCR), 2 pathologic complete remission (pCR), 10 partial remission (PR), 8 stable disease (SD)û while after FEC therapy, 9 patients showed cCR, 5 pCR, 20 PR, 10 SD. The most common adverse events were anemia, leukopenia, and nausea/vomiting. More cases of leukopenia were observed in GC group (18/22, P<0.05), and more cases of anemia in FEC group (29/40, P<0.05); the occurrence rates of gastroenteric reaction were similar in both groups. Only 1 patient in GC group suffered from oral mucositis; no renal toxicity and neurotoxicity were observed.


CONCLUSIONS
GC and FEC regimens are both effective for breast cancer with tolerable adverse events. The efficacy of FEC regimen is better than that of GT regimen.
Liu
Ke
K
Department of General Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, P. R. China. tomas-lk@163.com
Wang
Guo-Bin
GB
Cheng
Bo
B
Qiu
Deng-Bo
DB
D000740:Anemia / Q000139:chemically induced; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D015251:Epirubicin / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007970:Leukopenia / Q000139:chemically induced; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D020360:Neoadjuvant Therapy / Q000379:methods*; D009367:Neoplasm Staging; D012074:Remission Induction; D000093542:Gemcitabine
D003841:Deoxycytidine; D015251:Epirubicin; D003520:Cyclophosphamide; D002945:Cisplatin; D005472:Fluorouracil; D000093542:Gemcitabine