Evaluation of Epirubicin, Cyclophosphamide and Paclitaxel-based Chemotherapy Response for Treatment of Breast Cancer Patients as Neo-Adjuvant: A Case-Series in a Tertiary Care Hospital in Bangladesh

Abstract

Background: Breast cancer is the most common cancer among women across the world. Various treatment modalities in terms of radiotherapy, chemotherapy or surgery along with several neoadjuvant or adjuvant therapies are already established for the better survival of the patients. New modalities are still under research every other day for improvement of quality of life of cancer victims. Objective: This case series was conducted to assess the efficacy and safety profile of primary breast cancer patients by adding Paclitaxel to the established regimen of Epirubicin and Cyclophosphamide. Methods: This was performed during January 2019 to January 2021 with 9 cases of clinically diagnosed breast cancer patients at Combined Military Hospital, Dhaka. Patients included in our study received Epirubicin in the dose of 75-100 mg/m2 dl, Cyclophosphamide 600 mg/m2 dl, every 3 weeks for a total of 4 cycles followed by Paclitaxel at a dose of 175 mg/m2, every 3 weeks for a sum of 4 cycles. After every cycle of neoadjuvant chemotherapy and at the end of it, response was assessed by ultrasound. Results: The findings revealed 6 out of 9 patients showed pathological complete response at the end of this neoadjuvant regimen. The remaining 3 cases showed partial response. Toxicity was minimal and well-managed. 5 patients developed leukopenia in terms of haematological events, whereas for other effects, nausea and fatigue was commonly encountered. Conclusion: Overall, this treatment modality turned out to be feasible and a good option for neoadjuvant therapy in terms of efficacy and safety profile for the breast cancer patients.