Epirubicin and docetaxel as neoadjuvant treatment of locally advanced breast cancer: a phase II study.
OBJECTIVE
Neoadjuvant chemotherapy is the standard treatment for locally advanced breast cancer. The combination of anthracyclines and taxanes is considered the first choice chemotherapy in advanced breast cancer. We report here the overall results of a phase II study of epirubicin and docetaxel as neoadjuvant chemotherapy in advanced breast cancer.


METHODS
Forty-five patients with locally advanced, nonmetastatic breast carcinoma were treated with epirubicin, 90 mg/m2, docetaxel, 75 mg/m2, intravenously, every 3 weeks for 4 cycles before and 4 cycles after surgery, followed by tamoxifen for 5 years if estrogen receptor positive and radiation therapy if indicated. Patient characteristics included a median age of 45 years; pre Ipostmenopausal, 311/14 patients; T3-T4 in 33, N0/N1 in 12/33; ductal/lobular in 42/3; ER+ in 23; and HER2 overexpression in 23.


RESULTS
Clinical response included complete remission in 7 patients and partial remission in 27 (response rate, 75%). All 45 patients underwent surgery (quadrantectomy in 7). Histological examination of the breast and lymph nodes revealed no signs of disease in 3 patients and ductal carcinoma in situ only in 2. Twenty-five patients completed the chemotherapy program. G3-G4 toxicity included neutropenia in 39 patients. No other G3-4 toxicity nor toxic deaths occurred. Median relapse-free and overall survival were 35 and 56 months, respectively.


CONCLUSIONS
The neoadjuvant treatment was active and well tolerated, but the incidence of pathologic complete remissions was relatively low.
Lombardi
Davide
D
Division of Medical Oncology C, Centro di Riferimento Oncologico, Aviano, Italy. dlombardi@cro.it
Scalone
Simona
S
Crivellari
Diana
D
Magri
Maria Donatella
MD
La Mura
Nicoletta
N
Miolo
Gianmaria
G
Murrone
Antonio
A
Perin
Tiziana
T
Coran
Francesco
F
Candiani
Ezio
E
Massarut
Samuele
S
Veronesi
Andrea
A
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality; D017024:Chemotherapy, Adjuvant; D000077143:Docetaxel; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects
D043823:Taxoids; D000077143:Docetaxel; D015251:Epirubicin