title: Unfavorable pathological complete response rate of neoadjuvant chemotherapy epirubicin plus taxanes for locally advanced triple-negative breast cancer.
abstract: Anthracycline-Taxane chemotherapy is widely used in neoadjuvant treatment for breast cancers. However, there is limited data reported in patients with triple negative breast cancer (TNBC). Here, we evaluated the pathologic responses and survival of neoadjuvant epirubicin and taxanes chemotherapy in patients with locally advanced TNBC to provide some useful information for clinical practice. A total of 43 patients with locally advanced TNBC were enrolled in this study. Patients were administered with epirubicin 75 mg/m(2) plus paclitaxel 175 mg/m(2) or docetaxel 75 mg/m(2) every 3 weeks for at least 2 cycles. The primary endpoint was pathologic complete response (pCR), which was defined as no residual invasive cancer, or only carcinoma in situ in both the excised breast and axillary lymph node, while relapse-free survival (RFS) and overall survival (OS) were secondary endpoints. Thirty-nine (90.7%) patients were at clinical stages IIB-IIIC. Thirty-seven (86%) completed 4-6 cycles of preoperative chemotherapy, and objective response rate (ORR) was 81.4% (35/43). Forty-two patients underwent radical surgery subsequently. The pCR rate was 14.3% (6/42). The most common adverse events in neoadjuvant chemotherapy were nausea/vomiting (88.4%, 38/43) and neutropenia (88.4%). After a median follow-up period of 34.0 months, 3-year RFS and OS rate was 53.6% and 80.1%, respectively. All events of recurrence and death occurred in non-pCR patients, in whom the 3-year RFS and OS rates were 44.3% and 76.6%, respectively. This study suggest that neoadjuvant chemotherapy with epirubicin plus taxanes has a relatively low pCR rate and high early recurrence risk in locally advanced TNBC, which indicates the necessity for more efficacious treatment. Further study is needed to validate these results.
authors.affiliation: Department of Medical Oncology, Chinese Academy of Medical Sciences, Beijing, 100021, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Yin
authors.affiliation: Department of Medical Oncology, Chinese Academy of Medical Sciences, Beijing, 100021, China. zhang_pin@sina.com.
authors.forename: Pin
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Medical Oncology, Chinese Academy of Medical Sciences, Beijing, 100021, China.
authors.forename: Bing-He
authors.initials: BH
authors.lastname: Xu
authors.affiliation: Breast Surgical Department, Peking Union Medical College & Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, 100021, China.
authors.forename: Bai-Lin
authors.initials: BL
authors.lastname: Zhang
authors.affiliation: Department of Medical Oncology, Chinese Academy of Medical Sciences, Beijing, 100021, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Li
authors.affiliation: Department of Medical Oncology, Chinese Academy of Medical Sciences, Beijing, 100021, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Yuan
authors.affiliation: Department of Medical Oncology, Chinese Academy of Medical Sciences, Beijing, 100021, China.
authors.forename: Rui-Gang
authors.initials: RG
authors.lastname: Cai
authors.affiliation: Department of Medical Oncology, Chinese Academy of Medical Sciences, Beijing, 100021, China.
authors.forename: Jia-Yu
authors.initials: JY
authors.lastname: Wang
authors.affiliation: Breast Surgical Department, Peking Union Medical College & Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, 100021, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Wang
authors.affiliation: Breast Surgical Department, Peking Union Medical College & Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, 100021, China.
authors.forename: Xiao-Zhou
authors.initials: XZ
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D059186:Chemoradiotherapy, Adjuvant / Q000379:methods; D018572:Disease-Free Survival; D000077143:Docetaxel; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000517:prevention & control*; D018365:Neoplasm, Residual / Q000473:pathology / Q000517:prevention & control; D017239:Paclitaxel / Q000008:administration & dosage; D043823:Taxoids / Q000008:administration & dosage; D017211:Treatment Failure; D016896:Treatment Outcome; D064726:Triple Negative Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology*
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D015251:Epirubicin; D017239:Paclitaxel