A 2-month cisplatin-epirubicin-paclitaxel (PET) weekly combination as primary systemic therapy for large operable breast cancer: A phase II study

Giuseppe Frasci, G. D'Aiuto, P. Comella, R. Thomas, G. Botti, M. Di Bonito, M. D'Aiuto, G. Romano, M. R. Rubulotta, G. Comella

Research output: Contribution to journalArticle

Abstract

Purpose: The present study aimed to define the antitumor activity of eight cisplatin-epirubicin-paclitaxel (PET) weekly cycles with granulocyte colony-stimulating factor (G-CSF) support in patients with large operable breast cancer. Methods: Operable breast cancer (T2-3 N0- 1; T >3cm) patients received eight preoperative weekly cycles of cisplatin 30mg/m 2, epirubicin 50mg/m 2 and paclitaxel 120mg/m 2, with G-CSF (5μg/kg, days 3-5) support. Results: Sixty-three patients (T2/T 3=30/33; N0/N+=8/55) were enrolled. Thirty-one clinical complete (49%) and 30 partial (48%) responses were recorded, giving a 97% response rate (95% confidence interval 89% to 100%). Breast-sparing surgery was performed in 32/63 (51%) patients. At pathological assessment, 28 patients (45%) showed absence of invasive residual disease in breast and 34 (55%) had negative axilla. In 20 women (32%) both breast and axilla were found to be disease-free. At a 23-month median follow-up (range 4-63), only eight relapses and two deaths had occurred, with the 4-year projected relapse-free and overall survival being 59% and 95%, respectively. Grade 3-4 neutropenia and anemia occurred in 24% and 5% of patients, respectively. Emesis, diarrhea and mucositis were the main non-hematological toxicities; however, only nine (14%) patients experienced one or more episodes of severe non-hematological toxicity. Peripheral neuropathy was frequent, but never severe. Conclusions: A 2-month weekly treatment with PET represents a well tolerated and highly effective approach in large operable breast cancer patients. In spite of the short duration of chemotherapy, one-third of patients achieved a complete eradication of the tumor in both breast and axilla.

Original languageEnglish
Pages (from-to)1268-1275
Number of pages8
JournalAnnals of Oncology
Volume16
Issue number8
DOIs
Publication statusPublished - Aug 2005

Keywords

  • Cisplatin
  • Epirubicin
  • Operable breast cancer
  • Paclitaxel
  • Primary chemotherapy
  • Weekly administration

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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