Primary chemotherapy in breast cancer shows excellent clinical and pathological response with docetaxel and epirubicin

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10779-10779
Author(s):  
H. R. Marana ◽  
J. M. Andrade ◽  
D. G. Tiezzi ◽  
F. E. Zola ◽  
H. H. Carrara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Tumour Response ◽  
Conservative Surgery ◽  
Pathological Response ◽  
Advanced Breast ◽  
New Drugs ◽  
Primary Chemotherapy

10779 Background: Primary chemotherapy is becoming the standard of care for locally advanced breast cancer. Recently tested regimens using new drugs have been showing better results than usual anthracycline based treatments. Methods: From April 1998 through April 2004, 104 patients (18 stage IIA; 36 stage IIB; 13 stage IIIA; 33 stage IIIB; 4 stage IV) were included in the trial and received three cycles of docetaxel 75 mg/m2 and epirubicin 50 mg/m2 (q3w). Patients with stable or progressive disease were excluded from the trial, receiving alternative treatment. Those with partial response after three cycles but still not suitable for conservative surgery received up to 3 additional cycles. Following completion of the chemotherapy regimen, tumour response was assessed and appropriate surgery performed. Pathological response was evaluated in excised specimens. Results: According to the UICC criteria for clinical evaluation, 79 pts (76%) had objective regression (14 CR and 65 PR); 21 resulted in stabilised disease and 4 showed progression (24%). There was no toxicity in 62 patients, grade I/II in 4 and grade III/IV in seven patient. Ninity-nine patients became eligible for surgery (95%); 60 underwent conservative surgical treatment (60.6%) and in 39 patients a modified radical surgery was done (39.4%). No axyllary involvement were detected in 22 patients, other 23 had 1–3 positive nodes and 54 had 3 or more positives node in axillary dissection. 338 chemotherapy cycles were given, with an average of previously expected 3.25 cycles per patient. Conclusions: Our study demonstrates a high response rate with primary docetaxel and epirubicin chemotherapy in locally advanced breast cancer and high axillary envolvement group, enabling conservative surgery to take place and carrying no significant toxicity. Survival rate was directly linked to pathological response and complete response was associated to highest rate of survival in the group. No significant financial relationships to disclose.

scholarly journals Prediction of Chemoresistance in Women Undergoing Neo-Adjuvant Chemotherapy for Locally Advanced Breast Cancer: Volumetric Analysis of First-Order Textural Features Extracted from Multiparametric MRI

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
M. M. Panzeri ◽  
C. Losio ◽  
A. Della Corte ◽  
E. Venturini ◽  
A. Ambrosi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Volumetric Analysis ◽  
Pathological Response ◽  
Advanced Breast ◽  
Washout Rate ◽  
First Order

Purpose. To assess correlations between volumetric first-order texture parameters on baseline MRI and pathological response after neoadjuvant chemotherapy (NAC) for locally advanced breast cancer (BC). Materials and Methods. 69 patients with locally advanced BC candidate to neoadjuvant chemotherapy underwent MRI within 4 weeks from the start of therapeutic regimen. T2, DWI, and DCE sequences were analyzed and maps were generated for Apparent Diffusion Coefficient (ADC), T2 signal intensity, and the following dynamic parameters: k-trans, peak enhancement, area under curve (AUC), time to maximal enhancement (TME), wash-in rate, and washout rate. Volumetric analysis of these parameters was performed, yielding a histogram analysis including first-order texture kinetics (percentiles, maximum value, minimum value, range, standard deviation, mean, median, mode, skewness, and kurtosis). Finally, correlations between these values and response to NAC (evaluated on the surgical specimen according to RECIST 1.1 criteria) were assessed. Results. Out of 69 tumors, 33 (47.8%) achieved complete pathological response, 26 (37.7%) partial response, and 10 (14.5%) no response. Higher levels of AUCmax (p value = 0.0338), AUCrange (p value = 0.0311), and TME75 (p value = 0.0452) and lower levels of washout10 (p value = 0.0417), washout20 (p value = 0.0138), washout25 (p value = 0.0114), and washout30 (p value = 0.05) were predictive of noncomplete response. Conclusion. Histogram-derived texture analysis of MRI images allows finding quantitative parameters predictive of nonresponse to NAC in women affected by locally advanced BC.

scholarly journals Sequential dose-dense single agent chemotherapy for locally advanced breast cancer

2003 ◽  
Vol 11 (3) ◽  
pp. 149-149
Author(s):  
Svetislav Vrbic ◽  
Ivica Pejcic ◽  
Sladjana Filipovic ◽  
Stojan Radic
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Single Agent ◽  
Locally Advanced ◽  
Conservative Surgery ◽  
Advanced Breast ◽  
Dose Dense ◽  
Novel Concept ◽  
Single Agent Chemotherapy

Chemotherapy of breast cancer is still the area of intensive research. Based on mathematical model of tumor cell growth kinetics, articulated by Larry Norton, novel concept of chemotherapy in breast cancer was launched and it implies dose-densification of chemotherapy trough the use of sequential non cross-resistant single agents or regimens. The introduction of primary systemic chemotherapy (PST) improved the outcome of patients with locally advanced breast cancer (LABC). Simultaneous PST is the standard approach to patients with LABC nowadays. On the other hand, many studies using two most active cytotoxic drugs in primary breast cancer, anthracyclines and taxanes showed that sequential dose-dense single agent PST could be superior in terms of enhancing the rates of patients suitable for conservative surgery. In the light of this data, based on the results of the new clinical trials we will discuss merits and demerits of using sequential dose-dense single agent chemotherapy in LABC.

Radioimmunoguided surgery after primary treatment of locally advanced breast cancer.

1996 ◽  
Vol 14 (5) ◽  
pp. 1599-1603 ◽  
Author(s):  
P Percivale ◽  
S Bertoglio ◽  
P Meszaros ◽  
G Canavese ◽  
F Cafiero ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Primary Tumor ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Primary Chemotherapy ◽  
Radioimmunoguided Surgery ◽  
Group A ◽  
Group B

PURPOSE To assess the role of radioimmunoguided surgery (RIGS) using a handheld intraoperative gamma-detecting probe (GDP) to identify neoplastic disease after primary chemotherapy in locally advanced breast cancer (LABC) patients injected with iodine 125-labeled monoclonal antibodies (MAbs). PATIENTS AND METHODS Twenty-one patients with histologically documented LABC were treated with a combined modality approach. After three courses of primary chemotherapy and before modified radical mastectomy, the 125I-radiolabeled MAbs B72.3 (anti-TAG72) and FO23C5 (anti-carcinoembryonic antigen [CEA]) were administered to 11 patients (group A) and 10 patients (group B), respectively. At surgery, a GDP was used to locate the primary tumor and to assess possible tumor multicentricity and the presence of ipsilateral axillary metastases. Routine pathologic examination was performed in neoplastic and normal tissue specimens of all 21 patients. In addition, immunohistochemical assay for TAG72 and CEA expression was performed. RESULTS In group A patients, RIGS identified primary tumor in seven of 11 patients (63.3%) and unpalpable multicentric tumor lesions were located in two of four (50%). Positive axillary lymph nodes were histologically documented in eight of 11 patients (72.7%) and RIGS identified three of eight (37.5%). In group B, RIGS located the primary tumor lesion in four of 10 patients (40%); in two cases, the tumor was not clinically evident. Multicentricity was observed in one of two patients and lymph node involvement in three of nine (33.3%). No false-positive results were observed in either group A or B. CONCLUSION RIGS appears to be a safe and reliable technique. However, the MAbs used in this study are not sufficiently specific. RIGS represents a technique for which the full potential for intraoperative assessment of breast cancer lesions can be reached when more specific antibodies become readily available.

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