High complete pathological response in locally advanced breast cancer using paclitaxel and cisplatin

Citation
Aa. Ezzat et al., High complete pathological response in locally advanced breast cancer using paclitaxel and cisplatin, BREAST CANC, 62(3), 2000, pp. 237-244
Citations number
40
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
BREAST CANCER RESEARCH AND TREATMENT
ISSN journal
01676806 → ACNP
Volume
62
Issue
3
Year of publication
2000
Pages
237 - 244
Database
ISI
SICI code
0167-6806(200008)62:3<237:HCPRIL>2.0.ZU;2-T
Abstract
Background. In an earlier study, we have demonstrated a high response rate in metastatic breast cancer using paclitaxel (P) and cisplatin (C). A phase II study using the same regimen (PC) has been conducted in locally advance d breast cancer (LABC). Methods. A total of 72 consecutive patients with non-inflammatory LABC (T2 greater than or equal to 4 cm, T3 or T4, N0-N2, M0). Patients were schedule d to receive 3-4 cycles of the neoadjuvant PC (paclitaxel 135 mg/m(2) and c isplatin 75 mg/m(2) on day 1) every 21 days. Patients were then subjected t o surgery and subsequently received 6 cycles of FAC (5-fluorouracil 500 mg/ m(2), doxorubicin 50 mg/m(2), and cyclophosphamide 500 mg/m(2)) or 4 cycles of AC (doxorubicin 60 mg/m(2), and cyclophosphamide 600 mg/m(2)). Patients then received radiation therapy, and those with hormone receptor positive tumors were given adjuvant tamoxifen intended for 5 years. Results. The median age was 39 years (range, 24-78). Clinically, 7%, 58%, a nd 35% of patients had T2 greater than or equal to 4 cm, T3, and T4, respec tively. Disease stage at diagnosis was IIB (33%), IIIA (27%), and IIIB (40% ). Complete and partial clinical response to PC was demonstrated in 13 (18% ), and 52 (72%) patients, respectively. Of those patients with evaluable pa thologic response (68 patients), complete pathologic response (pCR) was ach ieved in 15 (22%) patients. At a median follow-up of 22 (+/- 3.5) months, 5 8 (81%) were alive with no recurrence, nine (12%) were alive with evidence of disease, and five (7%) were dead. None of the patients achieving pCR has developed any relapse. The median overall survival has not been reached fo r all 72 patients with a projected 3-year survival (+/- SE) of 90% (+/- 4%) . The median progression-free survival (PFS) was 42.1 (+/- 4.8) months with a projected PFS of 74% +/- 7% at 3-years (for 68 patients). Conclusions. PC regimen in LABC produced a high pCR. The contribution of th e other added modalities to survival could not be assessed.