Is it important to adapt neoadjuvant chemotherapy to the visible clinical response? An open randomized phase II study comparing response-guided and standard treatments in HER2-negative operable breast cancer
| Autor: | Hervé Curé, Pascale Dubray-Longeras, Qian Wang-Lopez, Christian Garbar, Guillaume Lebouedec, P. Chollet, Aude-Marie Savoye, Jean-Christophe Eymard, Marie-Ange Mouret-Reynier, Fabrice Kwiatkowski, Isabelle Van-Praagh, Frédérique Penault-Llorca, Catherine Abrial |
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| Rok vydání: | 2015 |
| Předmět: |
Oncology
Cancer Research medicine.medical_specialty Receptor ErbB-2 medicine.medical_treatment Phases of clinical research Breast Neoplasms Docetaxel Breast cancer Internal medicine Antineoplastic Combined Chemotherapy Protocols Medicine Humans Cyclophosphamide Neoadjuvant therapy Epirubicin Neoplasm Staging business.industry Standard treatment Clinical Trial Results medicine.disease Neoadjuvant Therapy Treatment Outcome Tolerability Fluorouracil Female Taxoids business medicine.drug |
| Zdroj: | The oncologist. 20(3) |
| ISSN: | 1549-490X |
| Popis: | Author Summary Background. Neoadjuvant treatment provides a unique opportunity to evaluate individual tumor sensitivity. This study evaluated whether a response-guided strategy could improve clinical outcome compared with a standard treatment. Methods. Overall, 264 previously untreated stage II–III operable breast cancer patients were randomized to receive either standard treatment (arm A, n = 131), consisting of fluorouracil, epirubicin, and cyclophosphamide (FEC100: 500, 100, and 500 mg/m2, respectively, for 3 cycles) followed by docetaxel (100 mg/m2 for 3 cycles), or adapted treatment (arm B, n = 133), beginning with 2 cycles of FEC100 and switching to docetaxel if tumor size decreased by Results. Similar results were observed for clinical response (objective response was 54% vs 56%, p = .18), breast conservation surgery (BCS; 67% vs 68%, p = .97), and pathological complete response rate (Chevallier classification: 14% vs 11%, p = .68; Statloff classification: 16% vs 13%, p = .82) between arms A and B. Similar toxicities were observed, even with unbalanced numbers of FEC100 and docetaxel courses. Conclusion. Adapted and standard treatments had similar results in terms of tumor response, BCS rate, and tolerability. Further survival outcome data are expected. |
| Databáze: | OpenAIRE |
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