Weekly epirubicin in the treatment of gestational breast cancer (GBC).
BACKGROUND
GBC is a rare disease and chemotherapy in this setting lacks a standardized approach.


METHODS
Patients 16-30 weeks pregnant with locally advanced/metastatic disease or with high risk of recurrence after surgery were evaluated.


RESULTS
Twenty patients received weekly epirubicin 35 mg/m(2). Median maternal age was 37 years (23-42). Median gestational age at chemotherapy was 19 weeks. Thirteen patients were treated after surgery while 7 had locally advanced tumours of which one had liver metastases. Mean total epirubicin dose was 420 mg/m(2) with a median number of 12 administrations (4-16). No grade 3-4 toxicities were observed. No foetal adverse events were observed except 1 premature delivery at 28 weeks. Births were induced by caesarean section in 12 patients at a median gestational age of 35 weeks. No malformations were reported except 1 newborn with polycystic kidney. At a median age of 2 years, neurological, cardiological and immunological development was normal in all children as reported by their parents. In 7/20 patients with evaluable disease, five had an objective response. At a median follow-up of 38 months, 17 patients are alive; 14 are disease free.


CONCLUSIONS
Weekly epirubicin appears safe and effective with low foetal toxicity and could be considered in GBC.
Peccatori
Fedro A
FA
Department of Medicine, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy. fedro.peccatori@ieo.it
Azim
Hatem A
HA
Scarfone
Giovanna
G
Gadducci
Angiolo
A
Bonazzi
Cristina
C
Gentilini
Oreste
O
Galimberti
Viviana
V
Intra
Mattia
M
Locatelli
Marzia
M
Acaia
Barbara
B
Rossi
Piero
P
Cinieri
Saverio
S
Calabrese
Liliana
L
Goldhirsch
Aron
A
D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy*; D015251:Epirubicin / Q000627:therapeutic use*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000188:drug therapy; D009367:Neoplasm Staging; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011379:Prognosis; D015996:Survival Rate
D000903:Antibiotics, Antineoplastic; D015251:Epirubicin