Neoadjuvant dose-dense gemcitabine plus docetaxel and vinorelbine plus epirubicin for operable breast cancer: Improved prognosis in triple-negative tumors

被引：9

作者：

Medioni J. ^{[1
,2
]}

Huchon C. ^{[2
,3
]}

Le Frere-Belda M.-A. ^{[4
]}

Hofmann H. ^{[3
,5
]}

Bats A.-S. ^{[2
,3
]}

Eme D. ^{[1
]}

Andrieu J.-M. ^{[1
,2
]}

Oudard S. ^{[1
,2
,6
]}

Lecuru F. ^{[2
,3
]}

Levy E. ^{[1
]}

机构：

[1] Département d'Oncologie Médicale, Hôpital Européen Georges Pompidou, Cedex 15, 75908, Paris, 20, rue Leblanc

[2] Paris Descartes University, Paris

[3] Department of Gynecological and Oncological Surgery, Georges Pompidou European Hospital, Paris

[4] Pathology Department, Georges Pompidou European Hospital, Paris

[5] Surgery Service, Clinique Saint Jean de Dieu, Paris

[6] EA 4054 University Paris Descartes, Georges Pompidou European Hospital, Public Assistance Hospital of Paris, Paris

来源：

Drugs in R & D | 2011年 / 11卷 / 2期

关键词：

Breast-cancer; Docetaxel; Epirubicin; Gemcitabine; Vinorelbine;

D O I：

10.2165/11591210-000000000-00000

中图分类号：

学科分类号：

摘要：

Background: Neoadjuvant anti-tumor activity of an alternating taxane- and anthracycline-based dose-dense regimen in patients with operable, noninflammatory large breast cancer was investigated. Objective: The objective is to study the rate of pathological complete response in patients with breast cancer receiving dose-dense chemotherapy sequentially with gemcitabine plus docetaxel and vinorelbine plus epirubicin. Methods: Women (n = 74) with clinical stage II or III breast cancer were enrolled in this open-label, multicenter study to receive six 2-weekly courses of gemcitabine 1000 mg/m 2 plus docetaxel 75 mg/m 2 on days 1 and 15, and vinorelbine 25 mg/m 2 plus epirubicin 100mg/m 2 on days 29 and 43. Patients with an objective response on day 56 then received another cycle of gemcitabine/ docetaxel on day 57 and of vinorelbine/epirubicin on day 71. Conservative surgery was scheduled for all patients. Results: Of the patients enrolled, 30% had triple-negative breast cancer (TNBC). The pathologic complete response (pCR) rate was 22% overall, but was higher in TNBC than patients without TNBC (40.9% vs 14.0%; p = 0.028). Among patients with a pCR, patients with TNBC had similar recurrence-free survival (RFS) and overall survival (OS) to patients without TNBC. Among those without a pCR, RFS rates for patients with TNBC were significantly lower than for patients without TNBC (p = 0.04). The most common severe hematologic toxicity was neutropenia. Conclusions: Administering four drugs in a dose-dense alternating sequence gave a high pCR in patients with operable, invasive breast cancer. Patients with TNBC with a pCR had similar OS to patients without TNBC, whereas patients with TNBC without a pCR had poorer survival rate than their non-TNBC counterparts. © 2011 Escudier & Gore, publisher and licensee Adis Data Information BV.

引用

页码：147 / 157

页数：10

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