title: Comparison of Doxorubicin plus docetaxel neoadjuvant chemotherapy with Doxorubicin plus vinorelbine in primary breast cancer.
abstract: OBJECTIVE
  This study was performed to compare the therapeutic efficacy and toxicity of doxorubicin plus docetaxel neoadjuvant chemotherapy (NC) with doxorubicin plus vinorelbine NC.
  
  
  METHODS
  Fifty-three patients underwent 4 cycles of NC consisted of intravenous injection of doxorubicin (50 mg/m(2)) plus docetaxel (75 mg/m(2)) administered every 3 weeks (AD), while 49 patients underwent 4 cycles of NC consisted of intravenous injection of doxorubicin (50 mg/m(2)) and vinorelbine (25 mg/m(2)) administered every 3 weeks (AN). Response rate and treatment-related toxicities were analyzed by administered chemotherapeutics. Response to NC was also analyzed according to clinicobiological characteristics of the primary tumors.
  
  
  RESULTS
  Clinical response was observed in 66% with AN and 81.6% with AD chemotherapy. A complete pathologic response (pCR) was confirmed in 6 patients (11.3%) with AN and in 7 patients (14.3%) with AD after the surgery. Response rate was significantly higher in AD compared with AN (p=0.038), but there was no significant difference between the two group regard to pCR rate. Breast conserving surgery (BCS) was performed in 35.8% of AN group, whereas 20 patients (40.8%) of AD group underwent BCS. The patients with HER2-amplified tumor showed significantly increased response to both types of NC. Pathologic complete response was confirmed in 9 (39.1%) out of 23 HER2-amplified tumors, whereas only 4 (5.1%) of 79 HER2-nonamplified tumors showed pathologic complete response. Febrile neutropenia occurred in 22.6% of total 212 cycles in AN and 38.8% of total 196 cycles in AD. Grade 3/4 neutropenia was observed in 39.6% in AN and 43.9% in AD. Grade 3 mucositis was observed in 26.4% with AN and in 40.8% with AD.
  
  
  CONCLUSIONS
  There was no significant increase of pCR by AD compared with AN. Long-term follow-up results of our study indicate that clinical outcome after NC was significantly associated with initial response to NC regardless of therapeutic regimens.
authors.affiliation: Department of Surgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
authors.forename: Geumhee
authors.initials: G
authors.lastname: Gwak
authors.forename: Ji-Young
authors.initials: JY
authors.lastname: Kim
authors.forename: Keongmee
authors.initials: K
authors.lastname: Park
authors.forename: Young Joo
authors.initials: YJ
authors.lastname: Shin
authors.forename: Hyunjin
authors.initials: H
authors.lastname: Cho
authors.forename: Sung Jin
authors.initials: SJ
authors.lastname: Park
authors.forename: Geun Ho
authors.initials: GH
authors.lastname: Yang
authors.forename: Byung Noe
authors.initials: BN
authors.lastname: Bae
authors.forename: Ki Whan
authors.initials: KW
authors.lastname: Kim
authors.forename: Sehwan
authors.initials: S
authors.lastname: Han