Which is your choice? Neoadjuvant doxorubicin hydrochloride and doxetaxel (AD) versus doxorubicin hydrochloride, cyclophosphamide, and paclitaxel (AC-T) in locally advanced breast cancer.

Abstract

e11559 Background: It is well known that neoadjuvnat chemotherapy is acceptable for women with locally advanced breast cancer. However, it is not achieving consensus that what kind of regimen is most effective and tolerable, although lots of regimens and dosages were clinically used. Methods: We compared the patients who were received adriamycine and doxetaxel (AD) and adriamycin, cyclophosphamide followed by paclitaxel (AC-T) as neoadjuvant chemotherapy and then received operation from 1 January 2006 to 30 September 2011. The group of AD regimen was scheduled for 3 cycles of AD (50mg/m2 and 75mg/m2, respectively) with 3 weeks interval and then completes resection. The group of AC-T was scheduled for 4 cycles of AC regimen (50mg/m2 and 500mg/m2, respectively) and then 4 cycles of paclitaxel(175mg/m2) with 3 weeks interval and then completes resection. Results: The patients who were enrolled in this study were totally 78(AD and AC-T were equally 38.) The significant differences of patients’ characteristics between two groups were not observed. However, the significant differences were identified in hematologic toxicity including neutropenia more than grade 3 p<0.001), neutropenic fever p<0.001), dose reduction rate due to hematologic toxicity (p=0.012) and chemotherapy induced anemia (p=0.012)), although chemotherapy induced thrombocytopenia (p=1.0) was not different between two groups. No differences were identified in non-hematologic toxicity including hepatic toxicity, gastrointestinal toxicity and peripheral neuropathy. The response of chemotherapy was no difference between two groups, which was estimated by conversion rate of breast conserving surgery, clinical response of chemotherapy (p=0.148), clinically downstaging rate (p=0.464) and pathologic complete response rate (p=1.0). There is no factor to predicting pathologic complete response or conversion to breast conservation in this study. Conclusions: The neoadjuvant AC-T regimen is more tolerable with similar clinical outcome compared to AD regimen.