Genetic Association of CYP1B1 4326 C>G Polymorphism with Disease-Free Survival in TNBC Patients Undergoing TAC Chemotherapy Regimen

Purpose: This study was designed to determine whether increasing the dose of doxorubicin in or adding paclitaxel to a standard adjuvant chemotherapy regimen for breast cancer patients would prolong time to recurrence and survival. Patients and Methods: After surgical treatment, 3,121 women with operable breast cancer and involved lymph nodes were randomly assigned to receive a combination of cyclophosphamide (C), 600 mg/m2, with one of three doses of doxorubicin (A), 60, 75, or 90 mg/m2, for four cycles followed by either no further therapy or four cycles of paclitaxel at 175 mg/m2. Tamoxifen was given to 94% of patients with hormone receptor–positive tumors. Results: There was no evidence of a doxorubicin dose effect. At 5 years, disease-free survival was 69%, 66%, and 67% for patients randomly assigned to 60, 75, and 90 mg/m2, respectively. The hazard reductions from adding paclitaxel to CA were 17% for recurrence (adjusted Wald χ2 P = .0023; unadjusted Wilcoxon P = .0011) and 18% for death (adjusted P = .0064; unadjusted P = .0098). At 5 years, the disease-free survival (± SE) was 65% (± 1) and 70% (± 1), and overall survival was 77% (± 1) and 80% (± 1) after CA alone or CA plus paclitaxel, respectively. The effects of adding paclitaxel were not significantly different in subsets defined by the protocol, but in an unplanned subset analysis, the hazard ratio of CA plus paclitaxel versus CA alone was 0.72 (95% confidence interval, 0.59 to 0.86) for those with estrogen receptor–negative tumors and only 0.91 (95% confidence interval, 0.78 to 1.07) for patients with estrogen receptor–positive tumors, almost all of whom received adjuvant tamoxifen. The additional toxicity from adding four cycles of paclitaxel was generally modest. Conclusion: The addition of four cycles of paclitaxel after the completion of a standard course of CA improves the disease-free and overall survival of patients with early breast cancer.

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Neoadjuvant Chemotherapy with Taxotere-Epirubicin-5-Fluorouracil (TEF) in Local-Regionally Advanced Breast Cancer: A Preliminary Report

Tumori Journal ◽

10.1177/030089160208800608 ◽

2002 ◽

Vol 88 (6) ◽

pp. 474-477 ◽

Cited By ~ 4

Author(s):

Eşmen Baltali ◽

M Kadri Altundağ ◽

Demir Ali Onat ◽

Osman Abbasoğlu ◽

Yavuz Özişik ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Neoadjuvant Chemotherapy ◽

Advanced Breast Cancer ◽

Chemotherapy Regimen ◽

Disease Free Survival ◽

Advanced Breast ◽

Free Survival ◽

The Mean ◽

Disease Free

Aims and background Sixty-three patients with local-regionally advanced breast cancer were treated with neoadjuvant chemotherapy consisting of docetaxel (Taxotere), epirubicin, and 5-fluorouracil (TEF). Methods and study design Preoperatively, patients received four cycles of Taxotere (80 mg/m2), epirubicin (60 mg/m2), and 5-fluorouracil (500 mg/m2), repeated every 21 days. Following completion of four cycles of chemotherapy, appropriate surgery was performed. After the surgery, patients received one cycle of the TEF chemotherapy regimen; following chemotherapy, radiotherapy was applied, and at the end two more cycles of TEF chemotherapy regimen were given. Results Sixty-three patients with locally advanced breast cancer were treated. Three patients were excluded from the study before the evaluation of response. Median age of the patients was 50 years (range, 25–77). Twenty-seven and 33 patients were premenopausal and postmenopausal, respectively. Thirty-nine patients were in stage IIIA and 21 in stage IIIB. Complete and partial responses were observed in 15 (25%) and 42 (70%) of the patients following four cycles of preoperative TEF chemotherapy regimen, respectively. Overall response was 95%, and primary lesion progressed only in 3 (5%) patients. The mean disease-free survival was 15.9 ± 6.8 (range, 3.5–28) months and the mean overall survival was 18.6 ± 7.2 (range, 5–30) months. The most frequent side effects were nausea-vomiting, mucositis, alopecia and leukopenia. Conclusions TEF therapy is a treatment with a high overall response rate and toxicities similar to other taxotere combinations. A longer follow-up of patients is necessary for the determination of disease-free survival and overall survival.

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Variables Associated to Pathologic Complete Response, Overall Survival and Disease-Free Survival in the Neoadjuvant Setting for Esophageal Cancer: A Retrospective Cohort Analysis

International Surgery ◽

10.9738/intsurg-d-18-00041.1 ◽

2018 ◽

Vol 103 (3-4) ◽

pp. 214-221 ◽

Cited By ~ 2

Author(s):

Flávio Roberto Takeda ◽

Mateus Silva Viyuela ◽

Jurandir Batista da Cruz Junior ◽

Francisco Tustumi ◽

Oddone Freitas Melro Braghiroli ◽

...

Keyword(s):

Esophageal Cancer ◽

Neoadjuvant Therapy ◽

Retrospective Cohort ◽

Cellular Differentiation ◽

Chemotherapy Regimen ◽

Pathologic Complete Response ◽

Disease Free Survival ◽

Complete Response ◽

Free Survival ◽

Disease Free

Objective: The aim of the study was to evaluate prognostic factors during neoadjuvant therapy that can predict pathologic complete response (pCR), overall survival (OS), or disease-free survival (DFS). Summary of background data: Variables that can predict tumor response to neoadjuvant therapy are required for esophageal cancer management. Methods: A retrospective cohort was performed with esophageal cancer patients submitted to neoadjuvant therapy. pCR, OS, and DFS were evaluated. Logistic regression was used to evaluate prognostic factors. This study covered 140 patients, 94 squamous cell carcinomas (SCC), and 44 adenocarcinomas. SCC is more often associated with pCR (compared to adenocarcinoma, OR: 8.07, 95% CI: 2.91–22.38); it has higher probability of DFS (HR for death or recurrence was 0.6, 95% CI: 0.37–0.98); and a higher probability of OS (HR for death was 0.59, 95% CI: 0.35–1). Gender, age, grade of cellular differentiation, chemotherapy regimen, and neoplasm circumferential involvement before neoadjuvant therapy are variables that are unrelated to DFS. Relief of dysphagia, and weight gain were also unrelated to the outcomes. In the multivariate analysis, the weight loss during neoadjuvant therapy was related to higher risk for recurrence or death (HR 1.02, 95% CI: 1–1.04). SCC histologic type was associated with higher probability of pCR, and higher OS and DFS rates. Gender, grade of cellular differentiation, and chemotherapy regimen are variables that are unrelated to pCR, OS, and DFS. Relief of dysphagia and increased levels of albumin after neoadjuvant therapy were also unrelated to the studied outcomes. Weight loss during neoadjuvant chemotherapy was associated with poor DFS rate in the multivariate analysis.

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Treatment of Indolent Lymphomas with 3 CNOP- 4 COPB.

Blood ◽

10.1182/blood.v104.11.4594.4594 ◽

2004 ◽

Vol 104 (11) ◽

pp. 4594-4594

Author(s):

Edgar Murillo ◽

Maria Nambo ◽

Agustin Aviles ◽

Natividad Neri ◽

Alejandra Talavera ◽

...

Keyword(s):

Response Rate ◽

Chemotherapy Regimen ◽

Disease Free Survival ◽

Complete Response ◽

Bulky Disease ◽

Free Survival ◽

Grade 3 ◽

Indolent Lymphomas ◽

Disease Free

Abstract Frequently recurrences and progressive resistance to chemotherapy characterize indolent lymphomas. The use of anthracyclines has been improved the response rate and the disease free survival, however, its use in elderly patients is controversial because the related toxicities. We analyze the use of a chemotherapy regimen with a short course of anthracycline. Material and Methods: We included patients with untreated indolent lymphomas according to the WHO classification. The chemotherapy regimens were 3 cycles of CNOP (cyclophosphamide 600 mg/m2 day 1, mitoxantrone 10 mg/m2 day1, vincristine 1.4 mg/m2 day 1 and prednisone 50 mg/m2 days 1–5) every 21 days, followed by 4 cycles of COPB (cyclophosphamide 800 mg/m2 day 1, vincristine 1.4 mg/m2 day 1, a bleomycin 10 U/m2 day 1 and prednisone 50 mg/m2 days 1–5) every 14 days. Results: In an intent to treat 75 patients were valuable, 37 females and 38 males, median age was 56 (range 28–84), the histological variants were: follicular grade 1 and 2 (45 patients), lymphoma/leukemia of small well differentiated lymphocytes (6 patients), mantle cell lymphoma (1 patient), nodal marginal zone lymphoma (4 patients), lymphoplasmocytic lymphoma (1 patient), indolent lymphoma not otherwise characterized (12 patients), 61 patients (81.3%) had bulky disease, 57 patients (76%) had advanced disease (stage III and IV). According to the IPI: low risk (28 patients), low intermediate (21 patients), high intermediate (14 patients), and high (12 patients). A total of 488 cycles were administrated, 82 (16.8%) cycles had hematologic toxicities: 30 cycles grade 1, 29 cycles grade 2, 18 cycles grade 3, and 5 cycles grade 4. Filgrastim was needed in 20 patients (43 cycles). 58 patients had gastrointestinal toxicity (29 grade1, 26 grade 2, 3 grade 3), 61 patients had neurological toxicity (47 grade 1, 13 grade 2, 1 grade 3). 14 patients (18.7%) required hospitalization, 7 patients due to toxicity related chemotherapy and 6 due to tumor progression. The overall response rate was 84% (63 patients): Complete response 33 patients (44%), unconfirmed complete response 6 patients (8%), partial response 24 patients (32%). Failure to treatment occurred in 11 patients (14.7%). Adding radiotherapy 12 more patients were converted to complete response for a total of 45 patients (60%). With a median of follow up of 24 months (range 3–62 months) 10 patients (13.3%) relapsed, 13 (17.3%) patients died (8 due to tumor progression and 3 related to toxicity of the regimen). The actuarial 5-year disease free survival was 71% and the overall survival 86%. Conclusions: This chemotherapy regimen provides an effective alternative for the treatment of indolent lymphomas even in advanced or bulky disease. This regimen is well tolerated for elderly patients and has a good safety profile. It is necessary a long time of follow up to establish the importance of the regimen in free disease survival and in overall survival.

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