Long-term follow-up of dose-dense neoadjuvant chemotherapy in patients with stage II/III breast cancer.

Academic Article

Abstract

  • e11048 Background: Prior studies have shown that women with operable breast cancer had no improvement in disease free survival (DFS) or overall survival (OS) having received chemotherapy (AC) either pre or postoperatively. However, they were able to delineate a subset of women who had improvement in DFS and OS. Achieving a pathological complete remission (pCR) was directly proportional to DFS and OS. Dose dense adjuvant chemotherapy (ATC) has shown a statistically significant improvement in DFS and OS. METHODS: We performed a single institution review of patients (pts) enrolled in a neoadjuvant trial who received dose dense neoadjuvant chemotherapy (doxorubicin 60mg/m2 IV Q2wks x4, paclitaxel 175mg/m(2)IV Q2wks x4 and cyclophosphamide 600 mg/m(2) IV Q2wks x4) to asses response rates, safety and DFS. Women with newly diagnosed breast cancer T > 3cm, any N, and M0 were enrolled. RESULTS: Since 2/2003, 48 pts were enrolled in a trial at UAB (mean age 48.7, range 28-64) and received dose dense chemotherapy. The median follow up is 67.9 months (range 8-88 months). Forty one pts completed dose dense chemotherapy and underwent surgery. Seventeen (41.4%) pts achieved a pCR in the breast and of those 14 (34%) pts were also pathologically negative in axillary lymph nodes. Ten of the 17 pts with pCR in the breast were triple negative. Nine pts have had disease relapse including one pt (HER2+) who had achieved a pCR. Two pts had febrile neutropenia, 2 pts had grade 3 anemia and none with grade 4 thrombocytopenia or anemia. Non hematological grade 3 or 4 toxicity included: venous thrombosis 3 pts, hyperglycemia 2 pts, syncope 1 pt, varicella zoster 1 pt and neuropathy in 2 pts. CONCLUSIONS: Our results show that dose dense neoadjuvant chemotherapy is effective, achieving high number of pCRs (breast and node) in triple negative and HER2+ breast cancer subtypes as opposed to hormone receptor positive cancers, with tolerable toxicity. Achieving a pCR is an important factor predicting the subsequent risk of relapse across all tumor types. [Table: see text].
  • Pubmed Id

  • 8069866
  • Author List

  • Nimmagadda S; Nabell L; Carpenter JT; Falkson CI; Krontiras H; De Los Santos JF; Urist MM; Bland KI; LoBuglio AF; Li Y
  • Start Page

  • e11048
  • Volume

  • 29
  • Issue

  • 15_suppl