Anthracycline-Free Neoadjuvant Chemotherapy Ensures Higher Rates of Pathologic Complete Response in Breast Cancer
| Autor: | Francesca De Iuliis, Katia Cefalì, Susanna Scarpa, Gerardo Salerno, Rosina Lanza, Debora D'Aniello, Ludovica Taglieri, Raffaella Corvino |
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| Rok vydání: | 2016 |
| Předmět: |
0301 basic medicine
Oncology Cancer Research medicine.medical_specialty Anthracycline Paclitaxel medicine.medical_treatment Breast Neoplasms survival taxane Carboplatin pathologic complete response 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Breast cancer Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Anthracyclines Prospective Studies Survival rate Neoadjuvant therapy Neoplasm Staging Chemotherapy Taxane business.industry toxicity Middle Aged Trastuzumab medicine.disease Prognosis Neoadjuvant Therapy Survival Rate 030104 developmental biology chemistry Chemotherapy Adjuvant carboplatin 030220 oncology & carcinogenesis Case-Control Studies Hormonal therapy Female business Follow-Up Studies |
| Zdroj: | Clinical breast cancer. 17(1) |
| ISSN: | 1938-0666 |
| Popis: | Purpose Neoadjuvant chemotherapy (NCT) is a standard of care for locally advanced and initially inoperable breast cancer. NCT can test chemotherapy efficacy and can be followed by breast-conserving surgery. Considering taxanes as one of the most effective agents, we analyzed the efficacy of a neoadjuvant schedule without anthracyclines and based only on taxanes and carboplatin, trying to avoid cardiotoxicity, which is the most serious side effect correlated with anthracyclines. Patients and Methods We enrolled 61 patients with breast cancer, belonging to 4 subgroups, according to molecular phenotypes: 24 triple-negative/basal-like, 13 HER2-like, 20 luminal B, and 4 luminal A. All patients underwent weekly chemotherapy with carboplatin AUC2, paclitaxel 80 mg/m2, with trastuzumab (in case of HER2 positivity) 2 mg/kg, except for luminal A patients, who underwent only hormonal therapy. Among 61 patients, 26 (43%) received modified radical mastectomy and 35 (57%) received breast-conserving surgery. Results The patients obtaining pathologic complete response (pCR) were 20 (83%) of 24 triple-negative/basal-like, 10 (76%) of 13 HER2-like, 6 (30%) of 20 luminal B, and 3 (75%) of 4 luminal A. All the patients were evaluated for toxicity: no grade 4 was detected, 5 patients experienced grade 3 neuropathy, then reverted to G2 after chemotherapy discontinuation. At a minimum follow-up of 5 years, median overall survival was 48 months. Conclusion Taxane/carboplatin-based/anthracycline-free NCT is the best treatment for inoperable breast cancer in terms of efficacy and toxicity, because this approach avoids cardiotoxicity and obtains an optimal rate (64%) of pCR, with an important impact on survival. |
| Databáze: | OpenAIRE |
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