Response and Prognosis of Docetaxel and Cyclophosphamide as Neoadjuvant Chemotherapy in ER+ HER2- Breast Cancer: A Prospective Phase II Study

被引:5
|
作者
Hayashi, Naoki [1 ]
Yagata, Hiroshi [1 ,2 ]
Tsugawa, Koichiro [3 ]
Kajiura, Yuka [1 ]
Yoshida, Atsushi [1 ]
Takei, Junko [1 ]
Yamauchi, Hideko [1 ]
Nakamura, Seigo [1 ,4 ]
机构
[1] St Lukes Int Hosp, Dept Breast Surg Oncol, Tokyo, Japan
[2] Saitama Med Ctr, Dept Breast Care, Saitama, Japan
[3] St Marianna Univ, Sch Med, Dept Surg,Div Breast & Endocrine Surg, Kawasaki Ku, Tokyo, Japan
[4] Showa Univ, Dept Breast Surg Oncol, Sch Med, Tokyo, Japan
关键词
Complete response; Cyclophosphomide; Docetaxel; Estrogen receptor; HER2; PATHOLOGICAL COMPLETE RESPONSE; PROGESTERONE-RECEPTOR LOSS; STAGE; PACLITAXEL; CRITERIA; THERAPY; REGIMEN; WOMEN;
D O I
10.1016/j.clbc.2020.09.007
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Our prospective phase II study showed that a docetaxel and cyclophosphamide regimen as neoadjuvant chemotherapy achieved a high clinical response rate in patients with stage II to III estrogen receptor-positive human epidermal growth factor receptor 2-negative breast cancer. A docetaxel and cyclophosphomide regimen without anthracycline as neoadjuvant chemotherapy might be an option for patients with estrogen receptor-positive human epidermal growth factor receptor 2-negative breast cancer without high-risk factors. Background: Although a docetaxel and cyclophosphomide (TC) regimen without anthracycline as adjuvant therapy became one of the standard regimens especially for ER-positive (ER-)/human epidermal growth factor receptor 2-negative (HER2(-)) primary breast cancer, the efficacy of TC as neoadjuvant chemotherapy (NAC) is not known. We conducted the prospective trial to assess the efficacy of a TC regimen in the neoadjuvant setting for stage II to III ER+/HER2 primary breast cancer. Patients and Methods: A TC regimen that included 75 mg/m(2) of docetaxel and 600 mg/m(2) of cyclophosphamide for 4 cycles every 3 weeks was administered as NAC. Primary endpoints are the rate of clinical response (clinical partial response and clinical complete response) and pathologic complete response; secondary endpoints are the disease-free survival and overall survival rates. Results: Thirty (71.4%) of 42 tumors had clinical response. No patient achieved pathologic complete response. At the median follow-up period of 105.2 months (range, 12.1-119.7 months), the disease-free survival rate was 81.6%, and the distant disease-free survival rate was 86.8%. In terms of survival, only 1 patient died during the study period. The overall survival rate was 97.4% during the study period. Patients who developed distant recurrence had a trend to have progesterone receptor-negative or weakly positive compared with those who did not develop any recurrence (85.7% vs. 45.2%; P =.05). Conclusions: Our prospective study showed that a TC regimen as NAC achieved a high clinical response rate in stage II to Ill ER+/HER2(-) breast cancer. A TC regimen without anthracycline as NAC might be one of the options for patients with ER+/HER2(-) breast cancer without high-risk factors including progesterone receptor negativity. (C) 2020 Elsevier Inc. All rights reserved.
引用
收藏
页码:462 / 468
页数:7
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