Increased Feasibility of Weekly Epirubicin and Paclitaxel as Neoadjuvant Chemotherapy for Locally Advanced Breast Carcinoma

Publisher： Karger

E-ISSN： 2296-5262|28|6-7|339-344

ISSN： 2296-5270

Source： Oncology Research and Treatment, Vol.28, Iss.6-7, 2005-06, pp. : 339-344

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Abstract

Background: Primary systemic therapy (PST) with a combinationof epirubicin and paclitaxel achieves high responserates in locally advanced breast cancer (LABC),but considerable toxicity occurs and the patient’s complianceis poor. In this open-label phase II trial toxicitiy ofa weekly administration schedule was evaluated. Patientsand Methods: On days 1 and 8 of each 3-weekcycle, 45 patients with non-inflammatory breast cancerreceived epirubicin (35 mg/m2, intravenous bolus) followedby paclitaxel (80 mg/m2 in 500 ml of normal salineinfused over 3 h) for 3 cycles. Surgery was done 2 weeksafter primary chemotherapy, followed by another 6 cyclesof adjuvant CEF (cyclophosphamide 500 mg/m2,epirubicin 70 mg/m2, 5-fluorouracil 500 mg/m2) chemotherapy.Results: The median tumor size before and afterPST was 6.0 and 2.0 cm, respectively. The clinical responserate was 96%, including 24% complete remission;5 patients (11%) achieved pathologically complete response(pCR) including 3 patients with carcinoma in situ.Only 5 (11%) patients underwent breast conservingsurgery although there were 15 patients suitable. Axillarynodes were negative in 16 (36%) of the 45 patients.Febrile neutropenia was found in 1 patient. There was nosevere cardiac toxicity or serious adverse events. Conclusions:PST with weekly epirubicin and paclitaxel wasan effective and well-tolerated combination for LABC, althoughonly few patients underwent breast conservingsurgery.