Docetaxel and anthracycline-based neoadjuvant chemotherapy in breast cancer

Abstract

11590 Background: Reducing the primary tumor volume and increasing the breast conserving surgery (BCS) rate are the main roles of neoadjuvant chemotherapy (NAT) in breast cancer. The aim of this study was to evaluate the benefit in adding docetaxel to anthracycline neoadjuvant therapy for breast cancer. Methods: Retrospective cohort study comparing the efficacy of NAT for breast cancer in patients subjected to docetaxel (75mg/m2) and epirubicin (60mg/m2) or 5-fluorouracil (600mg/m2), epirubicin (60mg/m2) and cyclophosphamide (600mg/m2) combinations (DE and FEC group, respectively). The mean number of chemotherapy delivered was three (2 to 6) in both groups (p= 0.8). Forty-six patients in the FEC group and 90 patients in the DE group were clinical stage II. Stage III was observed in 95 and in 68 patients in the FEC and the DE groups, respectively. The primary endpoint was the clinical and pathologic response to primary chemotherapy. The BCS rate was compared. Results: In stage II patients, the objective clinical response (OR) rate was 70% in the FEC group and 81% in the DE group, and the complete clinical response was in 11% and 29% in the FEC and DE groups, respectively (p= 0.01). The complete pathologic response (pCR) rate was 2% in the FEC group and 14% in the DE group (p= 0.01). In stage III patients, the objective clinical response rate was 49.5% in the FEC group and 80% in the DE group with complete clinical response rate of 9.5% and 13% in FEC and DE groups, respectively (p= 0.0001). The complete pathologic response (pCR) rate was 3.3% and 7.7% in FEC and DE groups, respectively (p= 0.1). BCS rate was higher in patients treated with DE scheme (67.5% versus 53% in stage II patients; p= 0.002, and 43.5% versus 29.5% in stage III patients; p= 0.0003). Conclusions: The NAT with DE combination is more effective in terms of clinical and pathologic response propitiating higher BCS rate than the FEC combination in stage II and III breast cancer. No significant financial relationships to disclose.