1–36 The Use of Alternate, Non-Cross-Resistant Adjuvant Chemotherapy on the Basis of Pathologic Response to a Neoadjuvant Doxorubicin-Based Regimen in Women With Operable Breast Cancer: Long-term Results From a Prospective Randomized Trial

Purpose To evaluate the use of an alternate, non–cross-resistant adjuvant chemotherapy regimen in women with a poor pathologic response to a preoperative doxorubicin-based regimen. Patients and Methods Patients with locally advanced breast cancer received three cycles of vincristine, doxorubicin, cyclophosphamide, and prednisone (VACP) every 21 days followed by surgery. Patients with less than 1 cm3 residual tumor at mastectomy received an additional five cycles of VACP. Those with more than 1 cm3 residual tumor were randomly assigned to receive an additional five cycles of VACP or five cycles of vinblastine, methotrexate with calcium leucovorin rescue, and fluorouracil (VbMF). Results One hundred ninety-three patients were evaluable. Overall clinical response was seen in 83.4% after three cycles of VACP, whereas the pathologic complete response was 12.2%. One hundred six patients were randomly assigned to VACP or VbMF. Those receiving VbMF achieved higher relapse-free survival (RFS) and overall survival (OS) than those who received additional VACP, although the differences did not reach statistical significance. Initial stage of tumor, clinical complete response, and pathologic complete response were all associated with statistically superior survival rates. Conclusion Clinical and pathologic response to preoperative doxorubicin-based chemotherapy predicted for improved survival in women with operable breast cancer. For those with a poor response to initial neoadjuvant chemotherapy, treatment with VbMF was associated with a trend toward improved RFS and OS compared with those continuing with the doxorubicin regimen.

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Long-term results of a single-center prospective randomized trial assessing efficacy of a shortened course of adjuvant chemotherapy after radical cystectomy in patients with locally advanced bladder cancer

Central European Journal of Urology ◽

10.5173/ceju.2020.0032 ◽

2020 ◽

Keyword(s):

Bladder Cancer ◽

Adjuvant Chemotherapy ◽

Randomized Trial ◽

Radical Cystectomy ◽

Locally Advanced ◽

Prospective Randomized Trial ◽

Long Term Results ◽

Single Center ◽

Advanced Bladder Cancer

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Pathologic response rate for high-risk operable breast cancer after TNCF semi-intensive neoadjuvant chemotherapy: Updated data with long-term results.

Journal of Clinical Oncology ◽

10.1200/jco.2010.28.15_suppl.683 ◽

2010 ◽

Vol 28 (15_suppl) ◽

pp. 683-683

Author(s):

X. Durando ◽

H. Cure ◽

C. Abrial ◽

E. Goldschmidt ◽

F. Penault-Llorca ◽

...

Keyword(s):

Breast Cancer ◽

High Risk ◽

Neoadjuvant Chemotherapy ◽

Response Rate ◽

Operable Breast Cancer ◽

Pathologic Response ◽

Long Term Results ◽

Pathologic Response Rate

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Sequencing of Chemotherapy and Radiation Therapy in Early-Stage Breast Cancer: Updated Results of a Prospective Randomized Trial

Journal of Clinical Oncology ◽

10.1200/jco.2005.04.032 ◽

2005 ◽

Vol 23 (9) ◽

pp. 1934-1940 ◽

Cited By ~ 129

Author(s):

Jennifer R. Bellon ◽

Steven E. Come ◽

Rebecca S. Gelman ◽

I. Craig Henderson ◽

Lawrence N. Shulman ◽

...

Keyword(s):

Breast Cancer ◽

Randomized Trial ◽

Statistical Power ◽

Early Stage ◽

Conservative Surgery ◽

Early Stage Breast Cancer ◽

Prospective Randomized Trial ◽

Long Term Results ◽

Breast Cancer Patients

Purpose The optimal integration of chemotherapy with radiation (RT) for patients with early-stage breast cancer remains uncertain. We present the long-term results of a prospective randomized trial to address this question. Patients and Methods Two hundred forty-four patients were randomly assigned after conservative breast surgery to receive 12 weeks of cyclophosphamide, doxorubicin, methotrexate, fluorouracil, and prednisone (CAMFP) before RT (CT-first) or after RT (RT-first). Median follow-up for surviving patients was 135 months. Results There were no significant differences between the CT-first and RT-first arms in time to any event, distant metastasis, or death. Sites of first failure were also not significantly different. Conclusion Among breast cancer patients treated with conservative surgery, there is no advantage to giving RT before adjuvant chemotherapy. However, this study does not have enough statistical power to rule out a clinically important survival benefit for either sequence.

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