Efficacy and safety of neoadjuvant chemotherapy with concurrent liposomal-encapsulated doxorubicin, paclitaxel and trastuzumab for human epidermal growth factor receptor 2-positive breast cancer in clinical practice
| Autor: | Ángel L Guerrero, Aranzazu Fernández, Josefina Camps, Amparo Ruiz, Miguel Angel Climent, Francisco Gozalbo, María Carrascosa, Joaquín Gavilá, Vicente Guillem |
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| Rok vydání: | 2014 |
| Předmět: |
Oncology
Adult medicine.medical_specialty Paclitaxel Receptor ErbB-2 medicine.medical_treatment Estrogen receptor Breast Neoplasms Adenocarcinoma Polyethylene Glycols chemistry.chemical_compound Young Adult Breast cancer Trastuzumab Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Doxorubicin Aged Chemotherapy business.industry Remission Induction Hematology General Medicine Middle Aged medicine.disease Metastatic breast cancer Neoadjuvant Therapy Surgery Regimen Treatment Outcome chemistry Female business medicine.drug |
| Zdroj: | International journal of clinical oncology. 20(3) |
| ISSN: | 1437-7772 |
| Popis: | Based on previous results obtained with non-pegylated liposomal-encapsulated doxorubicin (TLC-D99) together with paclitaxel and trastuzumab in patients with human epidermal growth factor receptor 2 (HER2)-positive locally advanced or metastatic breast cancer (BC), a similar regimen was evaluated in the neoadjuvant setting in a prospectively selected series of consecutive patients with clinical stage II–III BC. Primary and secondary objectives included the rate of pathologic complete response (pCR), safety, and predictive factors of pCR. Patients received six cycles of TLC-D99 (50 mg/m2 every 3 weeks), paclitaxel (80 mg/m2 weekly) and trastuzumab (4 mg/kg initial dose and 2 mg/kg weekly). All patients underwent surgery after treatment. pCR was defined as the absence of invasive cancer cells in the breast and the axilla. Sixty-two patients with a median age of 46.6 years were analyzed. Stage IIIA was diagnosed in 43.5 % of patients and 14.5 % had inflammatory BC. Conservative surgery was performed in 46.8 % of the patients and pCR was achieved in 63 % (95 % CI 50.5–75.5). Patients with estrogen receptor (ER)-negative tumors presented a significantly higher pCR rate than patients with ER-positive tumors (74.4 vs 43.5 %; P = 0.028). Forty-five patients (72.6 %) completed study treatment and 80.6 % received at least five treatment cycles. No patients developed congestive heart failure and 14.5 % of patients showed a ≥10 % decrease in the left ventricular ejection fraction. The triple combination therapy assessed is effective and safe, offering a high pCR rate in patients with HER2-positive BC. |
| Databáze: | OpenAIRE |
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