Dose-dense primary chemotherapy, as part of multidisciplinary treatment, for inoperable stage III B breast cancer - Long-term results of a phase II trial

Bruno Massidda, Francesco Atzori, Antioco Scanu, Antonio Contu, Antonio Farris, Anna Maria Catino, Sergio Palmeri, Luigi Minerba, Maria Teresa Ionta

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Primary chemotherapy as part of multidisciplinary approach is the established treatment for inoperable stage III B breast cancer. The primary endpoints were conversion to operable disease and feasibility of conservative surgery (breast-conserving therapy: BCT); secondary were clinical and pathological complete response rate, local and distant control and safety of the primary regimen. Methods: Between 1998 and 2001, 40 inoperable breast cancer patients ≤60 years, 72% T4abc and 28% T4d, received 6 cycles of primary PEV dose-dense regimen: cisplatin 50 mg/m 2, epirubicin 100 mg/m 2 and vinorelbine 25 mg/m 2, i.v. (q 14). Modified radical mastectomy (MRM) or BCT was performed, followed by adjuvant chemotherapy, radiotherapy and hormone therapy. Results: All patients were converted to operable disease, and BCT was feasible in 24% of T4abc patients. After a median follow-up of 84 months (range 58-96), local and distant relapses were 7.5% (0% in BCT ) and 25% (25% in BCT), respectively. Clinical response was 80% (clinical complete response [cCR]: 20%); pathological complete response (pCR) was 40% in breast, 50% in axilla (pLN0); 32% both in breast and axilla. Neutropenia (G4, 30%), leukopenia (G4, 25%), alopecia (G2, 100%), nausea and vomiting (G4, 20%) were the most common toxicities. Conclusions: The PEV dose-dense regimen seems to be highly effective in terms of resectability and pCR. Toxicity, mainly hematological, was acceptable. Successful BCT is feasible, in selected patients, without compromising local and distant control.

Original languageEnglish
Pages (from-to)17-26
Number of pages10
JournalOncology
Volume72
Issue number1-2
DOIs
Publication statusPublished - Nov 2007

Fingerprint

Breast Neoplasms
Drug Therapy
Axilla
Breast
Modified Radical Mastectomy
Epirubicin
Adjuvant Radiotherapy
Segmental Mastectomy
Alopecia
Leukopenia
Therapeutics
Adjuvant Chemotherapy
Neutropenia
Nausea
Cisplatin
Vomiting
Hormones
Safety
Recurrence
vinorelbine

Keywords

  • Breast cancer
  • Breast-conserving therapy
  • Dose-dense chemotherapy
  • Inoperable T4
  • Local-regional relapse rate
  • Primary chemotherapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Dose-dense primary chemotherapy, as part of multidisciplinary treatment, for inoperable stage III B breast cancer - Long-term results of a phase II trial. / Massidda, Bruno; Atzori, Francesco; Scanu, Antioco; Contu, Antonio; Farris, Antonio; Catino, Anna Maria; Palmeri, Sergio; Minerba, Luigi; Ionta, Maria Teresa.

In: Oncology, Vol. 72, No. 1-2, 11.2007, p. 17-26.

Research output: Contribution to journalArticle

Massidda, Bruno ; Atzori, Francesco ; Scanu, Antioco ; Contu, Antonio ; Farris, Antonio ; Catino, Anna Maria ; Palmeri, Sergio ; Minerba, Luigi ; Ionta, Maria Teresa. / Dose-dense primary chemotherapy, as part of multidisciplinary treatment, for inoperable stage III B breast cancer - Long-term results of a phase II trial. In: Oncology. 2007 ; Vol. 72, No. 1-2. pp. 17-26.
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abstract = "Background: Primary chemotherapy as part of multidisciplinary approach is the established treatment for inoperable stage III B breast cancer. The primary endpoints were conversion to operable disease and feasibility of conservative surgery (breast-conserving therapy: BCT); secondary were clinical and pathological complete response rate, local and distant control and safety of the primary regimen. Methods: Between 1998 and 2001, 40 inoperable breast cancer patients ≤60 years, 72{\%} T4abc and 28{\%} T4d, received 6 cycles of primary PEV dose-dense regimen: cisplatin 50 mg/m 2, epirubicin 100 mg/m 2 and vinorelbine 25 mg/m 2, i.v. (q 14). Modified radical mastectomy (MRM) or BCT was performed, followed by adjuvant chemotherapy, radiotherapy and hormone therapy. Results: All patients were converted to operable disease, and BCT was feasible in 24{\%} of T4abc patients. After a median follow-up of 84 months (range 58-96), local and distant relapses were 7.5{\%} (0{\%} in BCT ) and 25{\%} (25{\%} in BCT), respectively. Clinical response was 80{\%} (clinical complete response [cCR]: 20{\%}); pathological complete response (pCR) was 40{\%} in breast, 50{\%} in axilla (pLN0); 32{\%} both in breast and axilla. Neutropenia (G4, 30{\%}), leukopenia (G4, 25{\%}), alopecia (G2, 100{\%}), nausea and vomiting (G4, 20{\%}) were the most common toxicities. Conclusions: The PEV dose-dense regimen seems to be highly effective in terms of resectability and pCR. Toxicity, mainly hematological, was acceptable. Successful BCT is feasible, in selected patients, without compromising local and distant control.",
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T1 - Dose-dense primary chemotherapy, as part of multidisciplinary treatment, for inoperable stage III B breast cancer - Long-term results of a phase II trial

AU - Massidda, Bruno

AU - Atzori, Francesco

AU - Scanu, Antioco

AU - Contu, Antonio

AU - Farris, Antonio

AU - Catino, Anna Maria

AU - Palmeri, Sergio

AU - Minerba, Luigi

AU - Ionta, Maria Teresa

PY - 2007/11

Y1 - 2007/11

N2 - Background: Primary chemotherapy as part of multidisciplinary approach is the established treatment for inoperable stage III B breast cancer. The primary endpoints were conversion to operable disease and feasibility of conservative surgery (breast-conserving therapy: BCT); secondary were clinical and pathological complete response rate, local and distant control and safety of the primary regimen. Methods: Between 1998 and 2001, 40 inoperable breast cancer patients ≤60 years, 72% T4abc and 28% T4d, received 6 cycles of primary PEV dose-dense regimen: cisplatin 50 mg/m 2, epirubicin 100 mg/m 2 and vinorelbine 25 mg/m 2, i.v. (q 14). Modified radical mastectomy (MRM) or BCT was performed, followed by adjuvant chemotherapy, radiotherapy and hormone therapy. Results: All patients were converted to operable disease, and BCT was feasible in 24% of T4abc patients. After a median follow-up of 84 months (range 58-96), local and distant relapses were 7.5% (0% in BCT ) and 25% (25% in BCT), respectively. Clinical response was 80% (clinical complete response [cCR]: 20%); pathological complete response (pCR) was 40% in breast, 50% in axilla (pLN0); 32% both in breast and axilla. Neutropenia (G4, 30%), leukopenia (G4, 25%), alopecia (G2, 100%), nausea and vomiting (G4, 20%) were the most common toxicities. Conclusions: The PEV dose-dense regimen seems to be highly effective in terms of resectability and pCR. Toxicity, mainly hematological, was acceptable. Successful BCT is feasible, in selected patients, without compromising local and distant control.

AB - Background: Primary chemotherapy as part of multidisciplinary approach is the established treatment for inoperable stage III B breast cancer. The primary endpoints were conversion to operable disease and feasibility of conservative surgery (breast-conserving therapy: BCT); secondary were clinical and pathological complete response rate, local and distant control and safety of the primary regimen. Methods: Between 1998 and 2001, 40 inoperable breast cancer patients ≤60 years, 72% T4abc and 28% T4d, received 6 cycles of primary PEV dose-dense regimen: cisplatin 50 mg/m 2, epirubicin 100 mg/m 2 and vinorelbine 25 mg/m 2, i.v. (q 14). Modified radical mastectomy (MRM) or BCT was performed, followed by adjuvant chemotherapy, radiotherapy and hormone therapy. Results: All patients were converted to operable disease, and BCT was feasible in 24% of T4abc patients. After a median follow-up of 84 months (range 58-96), local and distant relapses were 7.5% (0% in BCT ) and 25% (25% in BCT), respectively. Clinical response was 80% (clinical complete response [cCR]: 20%); pathological complete response (pCR) was 40% in breast, 50% in axilla (pLN0); 32% both in breast and axilla. Neutropenia (G4, 30%), leukopenia (G4, 25%), alopecia (G2, 100%), nausea and vomiting (G4, 20%) were the most common toxicities. Conclusions: The PEV dose-dense regimen seems to be highly effective in terms of resectability and pCR. Toxicity, mainly hematological, was acceptable. Successful BCT is feasible, in selected patients, without compromising local and distant control.

KW - Breast cancer

KW - Breast-conserving therapy

KW - Dose-dense chemotherapy

KW - Inoperable T4

KW - Local-regional relapse rate

KW - Primary chemotherapy

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