Prospective phase II study of neoadjuvant doxorubicin followed by cisplatin/docetaxel in locally advanced breast cancer

Taher A. Al-Tweigeri, Dahish S. Ajarim, Adher A. Alsayed, Mohamed M. Rahal, Mohamed O. Alshabanah, Asma M. Tulbah, Osama A. Al-Malik, Doha M. Fatani, Gamal A. El-Husseiny, Naser B. Elkum, Adnan A. Ezzat

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Abstract

The objective of this study is to evaluate the efficacy and safety profile of the doxorubicin followed by cisplatin/docetaxel as primary chemotherapy for patients with locally advanced breast cancer (LABC). For this evaluation, 59 patients with LABC (T2-T4, N0-N2, M0) received three cycles of doxorubicin, followed by three cycles of cisplatin/docetaxel and followed by definitive surgery and locoregional radiotherapy with or without tamoxifen. The primary end point was pathologic complete response (pCR) in breast and axilla. Fifty-nine patients were evaluable for analysis: median age: 41 years, premenopausal: 68%, median tumor size: 6.0 cm (4-10), Stage IIB: 32% and IIIA/IIIB: 68%, both ER/PR positive: 53%, Her2/neu (3+) by IHC staining: 29%. Clinical complete response was seen in 44%, and clinical partial response was seen in 56%. Breast conserving surgery was performed in 44%, and MRM in 56%. pCR in the breast was 30.5%, in axilla was 37%, and pCR in both breast and axilla was 24%. Overall at follow-up of 60 months, the disease-free (DFS) and overall survival (OS) were 70 and 82%, respectively. The DFS and OS of patients who achieved complete pathologic response in breast and axilla were 78 and 100%, respectively, while 14 patients relapsed of which 46% were Her2 positive. Sequential combination of doxorubicin followed by docetaxel/cisplatin is a safe, feasible, and active combination, which offers the possibility of conservative surgery and is associated with high clinical and pathologic response rates, with promising and encouraging survival outcomes.

Original languageEnglish
Pages (from-to)571-577
Number of pages7
JournalMedical Oncology
Volume27
Issue number3
DOIs
Publication statusPublished - 1 Sep 2010

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Keywords

  • Anthracycline
  • Cisplatin/docetaxel
  • Locally advanced breast cancer
  • Neoadjuvant chemotherapy
  • Pathologic complete response

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Al-Tweigeri, T. A., Ajarim, D. S., Alsayed, A. A., Rahal, M. M., Alshabanah, M. O., Tulbah, A. M., Al-Malik, O. A., Fatani, D. M., El-Husseiny, G. A., Elkum, N. B., & Ezzat, A. A. (2010). Prospective phase II study of neoadjuvant doxorubicin followed by cisplatin/docetaxel in locally advanced breast cancer. Medical Oncology, 27(3), 571-577. https://doi.org/10.1007/s12032-009-9251-7