In vivo chemosensitivity-adapted preoperative chemotherapy in patients with early-stage breast cancer: the GEPARTRIO pilot study
2004; Elsevier BV; Volume: 16; Issue: 1 Linguagem: Inglês
10.1093/annonc/mdi001
ISSN1569-8041
AutoresGϋnter von Minckwitz, Jens‐Uwe Blohmer, Günther Raab, Alfredo Löhr, B. Gerber, G. Heinrich, Holger Eidtmann, M. Kaufmann, J. Hilfrich, Christian Jackisch, I. Zuna, Serban Dan Costa,
Tópico(s)Cancer Risks and Factors
ResumoBackgroundResponse to the first two cycles of preoperative chemotherapy might differentiate subgroups of breast cancer patients with high or minimal chances for a pathologic complete response (pCR) and may be used as an in vivo chemosensitivity test.MethodsBreast cancer patients were treated with two cycles of TAC (docetaxel 75 mg/m2, doxorubicin 50 mg/m2, cyclophosphamide 500 mg/m2 every 21 days). Patients whose tumors showed a response received four more cycles. Patients whose tumors did not respond were randomized to four additional cycles TAC or NX (vinorelbine 25 mg/m2 days 1 and 8, capecitabine 2000 mg/m2 days 1–14, every 21 days). The primary end point was pCR at surgery.ResultsTwo hundred and eighty-five patients showed a clinical response, in 73.0% after two cycles, in 88.4% at surgery, and a pCR was seen in 17.9%. Breast conservation was possible in 72.2%. Responding patients obtained a pCR in 22.6% whereas non-responding patients reached a pCR in 7.3% and 3.1% with TAC or NX, respectively. Grade III/IV neutropenia and febrile neutropenia were observed during TAC in 70.2% and 13.5%, respectively. Significantly less toxicity were observed with NX.ConclusionEarly response to TAC can reliably identify patients with a high chance of achieving a pCR. New effective treatments need to be explored for patients without an early response.
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