Effect of neoadjuvant alternating taxane- and anthracycline-based dose-dense regimen for operable breast cancer on prognosis in triple-negative tumors with a complete histological response.

Abstract

610 Background: Neoadjuvant antitumour activity of an alternating taxane- and anthracycline-based dose-dense regimen in patients with operable, noninflammatory large breast cancer was investigated. Methods: Women (n = 74) with clinical stage II or III breast cancer were enrolled in this open-label, multicentre study to receive six twice-weekly courses of: gemcitabine 1,000 mg/m2 plus docetaxel 75 mg/m2 on days 1 and 15 and vinorelbine 25 mg/m2 plus epirubicin 100 mg/m2 on days 29 and 43. Patients with an objective response on day 56 then received another cycle of gemcitabine/docetaxel on day 57 and of vinorelbine/epirubicin on day 71. Conservative surgery was scheduled for all patients. Results: Of the patients enrolled, 30% had triple-negative breast cancer (TNBC). Thepathological complete response (pCR) rate was 22% overall, but was higher in TNBC than non-TNBC patients (40.9% versus 14.0%; p = 0.028). Among patients with a pCR, TNBC patients had similar recurrence-free survival (RFS) and overall survival (OS) to non-TNBC patients. Among those without a pCR, RFS rates for TNBC patients were significantly lower than for non-TNBC patients (p = 0.04). The most common severe haematological toxicity was neutropenia. Conclusions: Administering four drugs in a dose-dense alternating sequence gave a high pCR in patients with operable, invasive breast cancer. TNBC patients with a pCR had similar OS to non-TNBC patients, whereas TNBC patients without a pCR had poorer survival than their non-TNBC counterparts. No significant financial relationships to disclose.