Abstract
606 Background: Neoadjuvant chemotherapy is currently the standard of care for the management of locally advanced breast cancer, as it improves both disease-free and overall survival. Methods: Patients with histologic confirmation of locally advanced breast cancer, age >18 years, left ventricular ejection fraction >50%, good performance status and adequate bone marrow, negative chest and abdominal CT scan, renal and hepatic function were included in the study. Prior systemic therapy and radiotherapy and the presence of metastases were not allowed. The treatment schedule was as follows: GC: 1,250 mg/m2 (day 1); GC 1,000 mg/m2 plus TT 75 mg/m2 plus DX 30 mg/m2 (day 8). Pegfilgrastim was routinely administered as primary prophylaxis against febrile neutropenia. Courses were repeated each 21 days for 4–6 cycles. This study was aimed to assess the activity of GC, DX and TT in locally advanced breast cancer. Results: Fifty patients were enrolled and treated. Median age was 51 years (range: 34–73), 27 (54%) being postmenopausal patients. Infiltrating ductal carcinoma was diagnosed in 84% of cases. Tumor size was as follows: T1 (n=2, 4%), T2 (n= 31, 62%), T3 (n=14, 28%), T4 (n=2, 4%). G3 grading was found in 28% of cases. Median tumor size was 4 cm (range: 2–10). Tumors were ER+, PR+ and c-Erb-B2+ in 34 (68%), 31(62%) and 27 (54%) cases, respectively. Surgery was performed in 47 (94%) patients: 12 (26%) pathologic complete response, 24 (51%) partial response and 9 (19%) stable disease were observed resulting in a pathologic overall response rate of 77%. Logistic regression analysis revealed that larger tumor size, Mib1 higher expression and higher number of cycles were independently associated with better tumor response rates. Conclusions: This combination chemotherapy can yield a high tumor response rate. Correlation analysis suggests that this neoadjuvant regimen might be more effective in patients with larger tumors expressing Mib1, particularly if full treatment can be administered. No significant financial relationships to disclose.
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