title: Docetaxel and cyclophosphamide as neoadjuvant chemotherapy in HER2-negative primary breast cancer.
abstract: BACKGROUND
  Docetaxel plus cyclophosphamide (TC) has recently been established as a standard adjuvant chemotherapy regimen for HER2-negative (HER2-) operable breast cancer. However, the efficacy and tolerability of TC as neoadjuvant chemotherapy (NAC) remain unclear. We, therefore, conducted a prospective study to evaluate the efficacy of TC NAC in HER2- primary breast cancer.
  
  
  METHODS
  Patients who were diagnosed with HER2-, N0-N1, invasive breast cancer between July 2011 and February 2014 and had tumors measuring 1-7 cm were eligible. The subtypes were classified using a core-needle or vacuum-assisted breast biopsy. The efficacy and safety of NAC comprising TC (75 mg/m2docetaxel and 600 mg/m2cyclophosphamide, four cycles every 3 weeks) were investigated in a prospective study in patients with HER2- breast cancer.
  
  
  RESULTS
  Fifty-two patients were enrolled. Of these, 94.2 % (49/52) completed four cycles of TC. The overall pCR rate was 16.3 % (8/49). The pCR rates for patients with luminal A-like breast cancer [estrogen receptor-positive (ER+), Ki67 index of <20 %, and HER2-], luminal B-like breast cancer (ER+, Ki67 index of >20 %, and HER2-), and triple-negative breast cancer [ER-negative (ER-) and HER2-] were 0 % (0/12), 4.3 % (1/23), and 50.0 % (7/14), respectively. Almost all pCRs occurred in triple-negative breast cancer patients.
  
  
  CONCLUSIONS
  The pCR rate of TC NAC was not very high despite the high completion rate. TC NAC was effective against the triple-negative subtype, resulting in a higher pCR rate. Therefore, our results indicated that TC NAC showed limited efficacy in luminal subtype breast cancer with the exception of the triple-negative subtype.
authors.affiliation: Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. kacchan@koto.kpu-m.ac.jp.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Nakatsukasa
authors.affiliation: Nara City Hospital, Nara, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Koyama
authors.affiliation: Nara City Hospital, Nara, Japan.
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Oouchi
authors.affiliation: Nara City Hospital, Nara, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Imanishi
authors.affiliation: Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Naruhiko
authors.initials: N
authors.lastname: Mizuta
authors.affiliation: Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Kouichi
authors.initials: K
authors.lastname: Sakaguchi
authors.affiliation: Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Fujita
authors.affiliation: Ayabe City Hospital, Ayabe, Japan.
authors.forename: Ikuya
authors.initials: I
authors.lastname: Fujiwara
authors.affiliation: Saiseikai Kyoto Hospital, Nagaokakyo, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kotani
authors.affiliation: Saiseikai Kyoto Hospital, Nagaokakyo, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Matsuda
authors.affiliation: Saiseikai Shiga Hospital, Ritto, Japan.
authors.forename: Kenichirou
authors.initials: K
authors.lastname: Fukuda
authors.affiliation: Saiseikai Shiga Hospital, Ritto, Japan.
authors.forename: Midori
authors.initials: M
authors.lastname: Morita
authors.affiliation: Fukuchiyama City Hospital, Fukuchiyama, Japan.
authors.forename: Sadao
authors.initials: S
authors.lastname: Kawakami
authors.affiliation: Aiseikai Yamashina Hospital, Kyoto, Japan.
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Kadotani
authors.affiliation: Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Konishi
authors.affiliation: Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Yanagisawa
authors.affiliation: Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Taguchi
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D000077143:Docetaxel; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D011446:Prospective Studies; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome; D064726:Triple Negative Breast Neoplasms / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology
chemical_list: D003520:Cyclophosphamide; D000077143:Docetaxel; D018719:Erb-b2 Receptor Tyrosine Kinases; D043823:Taxoids; C508053:ERBB2 protein, human
keywords: Breast cancer; HER2-negative; Neoadjuvant chemotherapy