Unfavorable Pathological Complete Response Rate of Neoadjuvant Chemotherapy Epirubicin plus Taxanes for Locally Advanced Triple-negative Breast Cancer

• Published in: Journal of Huazhong University of Science and Technology. Medical sciences Vol. 33; no. 2; pp. 262 - 265
• Main Author: 尹一 张频 徐兵河 张柏林 李青 袁芃 蔡瑞刚 王佳玉 王翔 徐晓洲
• Format: Journal Article
• Language: English
• Published: Heidelberg Huazhong University of Science and Technology 01.04.2013; Department of Medical Oncology, Peking Union Medical College & Cancer Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China%Breast Surgical Department, Peking Union Medical College & Cancer Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Chemoradiotherapy, Adjuvant - methods; Disease-Free Survival; Epirubicin - administration & dosage; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neoadjuvant Therapy - methods; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - prevention & control; Neoplasm, Residual - pathology; Neoplasm, Residual - prevention & control; Paclitaxel - administration & dosage; Taxoids - administration & dosage; Treatment Failure; Treatment Outcome; Triple Negative Breast Neoplasms - drug therapy; Triple Negative Breast Neoplasms - pathology; 乳腺癌; 化疗; 多西紫杉醇; 晚期; 病理反应; 紫杉烷类化合物; 表阿霉素; 阴性; neoadjuvant chemotherapy; epirubicin; triple-negative breast cancer; pathological complete response; taxanes; survival
• ISSN: 1672-0733; 1993-1352
• DOI: 10.1007/s11596-013-1108-9

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 II B-IIIC. Thirty-seven （86%） completed 4-6 cycles of preop- erative chemotherapy, and objective response rate （ORR） was 81.4% （35/43）. Forty-two patients un- derwent 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 ad- vanced TNBC, which indicates the necessity for more efficacious treatment. Further study is needed to validate these results.