Neoadjuvant docetaxel for operable breast cancer induces a high pathological response and breast-conservation rate
Autor: | S. Amat, Ph. Chollet, Fétissof F, Jacques Dauplat, P Bougnoux, Hervé Curé, J.-L. Achard, Frédérique Penault-Llorca, Fabrice Kwiatkowski, Gilles Body |
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Rok vydání: | 2003 |
Předmět: |
Oncology
Cancer Research medicine.medical_specialty Paclitaxel medicine.medical_treatment Phases of clinical research Breast Neoplasms Docetaxel Methylprednisolone Drug Administration Schedule taxane Clinical Breast cancer Recurrence Internal medicine Humans Medicine Neoplasm Invasiveness induction breast Neoplasm Staging Chemotherapy Taxane business.industry neoadjuvant medicine.disease Antineoplastic Agents Phytogenic Survival Analysis Metastatic breast cancer Blood Cell Count Surgery Regimen Treatment Outcome Receptors Estrogen Tolerability Chemotherapy Adjuvant Injections Intravenous Female Taxoids Receptors Progesterone business medicine.drug |
Zdroj: | British Journal of Cancer |
ISSN: | 1532-1827 0007-0920 |
Popis: | Docetaxel (Taxotere), alone or in combination with other anticancer agents, has proven efficacy in the first- and second-line treatment of metastatic breast cancer. This phase II study investigated the efficacy and tolerability of docetaxel as neoadjuvant chemotherapy in women with stage II-III primary operable breast cancer. Patients (n=88) were treated with six cycles of docetaxel at 100 mg m(-2) every 21 days, followed by definitive surgery and radiotherapy. After six cycles of docetaxel, the overall clinical response rate was 68.4% (CI 95%: 58.1-78.7%), including 19.0% complete remissions. Breast conservation was achieved in 72.4% of patients. A high pathological complete response (pCR) rate in breast was confirmed in 15 patients (19.8% (CI 95%: 10.8-28.8%)) on Chevallier's classification restricted to breast and in 27 patients (35.5% (CI 95%: 24.7-46.3%)) on Sataloff's classification. After a median follow-up of 30.8 months, 19 recurrences were documented with a median time to first recurrence of 17.3 months. Patients with stage III tumours had more recurrences than patients with stage II tumours (P=0.02). The principal toxicity of docetaxel is myelosuppression and 70.5% of patients developed grade III or IV neutropenia with 13.6% developing neutropenic sepsis. There was no case of severe cardiac toxicity, thrombocytopenia or any other serious adverse events. In conclusion, neoadjuvant docetaxel induces a high pCR and breast-conservation rate. Docetaxel monotherapy is a highly effective regimen that merits formal comparison with currently used combination regimens in a randomised phase III study. |
Databáze: | OpenAIRE |
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