Is it Possible to Increase pCR in the Neoadjuvant Treatment With a Dose-Dense/Sequential Combination?

• DOI: 10.1097/coc.0b013e3181b4eff9
• Publication Date: 2010-03-27T09:24:09Z
• Authors: Alfonso Sánchez-M...; R. Dueñas-García; A. Jaén-Morago; E. Carrasco; I. Chacón; A. M. García-Tapi...; A. L. Ortega-Gran...; E. Martínez-Ortega; N. Ribelles; M. Fernández-Navarro; C. de la Torre-Ca...; B. Dueñas; A. I. Rueda; J. Martínez; C. Ramírez Tortosa; M. D. Martín-Salvago; P. Sánchez-Rovira
• Keywords: Epirubicin; Regimen; Neoadjuvant Therapy

To evaluate the pathologic complete response (pCR) rate of a combination epirubicin (E) and cyclophosphamide (C) followed by paclitaxel (P) gemcitabine (G) (+ trastuzumab[T]) in Her2+ patients) sequential dose-dense schedule as neoadjuvant chemotherapy for stages II III patients with breast cancer. Secondary endpoints: clinical rate, disease free survival, safety correlation between pCR biologic markers.Eligible were treated E (90 mg/m²) C (600 3 cycles (first sequence) P (150 G (2500 (second 6 cycles. All drugs administered on day 1, every 2 weeks, prophylactic growth factor support. Weekly T (2 mg/kg [4 first infusion]) was concomitantly patients. A core biopsy performed before treatment markers assessment. Patients underwent surgery, radiotherapy, adjuvant hormonal therapy according to institutional practice.Seventy-three treated. achieved 27 (37%) (32.1%, Her2- 50%, Her2+). significantly higher tumors that receptor negative, poorly differentiated positive Ki67 p53. Breast-conserving surgery 47 (64.4%). Most frequent grade 3/4 hematologic nonhematological toxicities included neutropenia (12%), nausea/vomiting (17%), transient liver enzymes elevation (7%). One patient suffered an asymptomatic reversible decrease left ventricular ejection fraction.These results show highly effective regimen terms good toxicity profile The addition trastuzumab increased tumors.