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Medical Oncology

, Volume 27, Issue 3, pp 571–577 | Cite as

Prospective phase II study of neoadjuvant doxorubicin followed by cisplatin/docetaxel in locally advanced breast cancer

  • Taher A. Al-TweigeriEmail author
  • Dahish S. Ajarim
  • Adher A. Alsayed
  • Mohamed M. Rahal
  • Mohamed O. Alshabanah
  • Asma M. Tulbah
  • Osama A. Al-Malik
  • Doha M. Fatani
  • Gamal A. El-Husseiny
  • Naser B. Elkum
  • Adnan A. Ezzat
Original Paper

Abstract

The objective of this study is to evaluate the efficacy and safety profile of the doxorubicin followed by cisplatin/docetaxel as primary chemotherapy for patients with locally advanced breast cancer (LABC). For this evaluation, 59 patients with LABC (T2–T4, N0–N2, M0) received three cycles of doxorubicin, followed by three cycles of cisplatin/docetaxel and followed by definitive surgery and locoregional radiotherapy with or without tamoxifen. The primary end point was pathologic complete response (pCR) in breast and axilla. Fifty-nine patients were evaluable for analysis: median age: 41 years, premenopausal: 68%, median tumor size: 6.0 cm (4–10), Stage IIB: 32% and IIIA/IIIB: 68%, both ER/PR positive: 53%, Her2/neu (3+) by IHC staining: 29%. Clinical complete response was seen in 44%, and clinical partial response was seen in 56%. Breast conserving surgery was performed in 44%, and MRM in 56%. pCR in the breast was 30.5%, in axilla was 37%, and pCR in both breast and axilla was 24%. Overall at follow-up of 60 months, the disease-free (DFS) and overall survival (OS) were 70 and 82%, respectively. The DFS and OS of patients who achieved complete pathologic response in breast and axilla were 78 and 100%, respectively, while 14 patients relapsed of which 46% were Her2 positive. Sequential combination of doxorubicin followed by docetaxel/cisplatin is a safe, feasible, and active combination, which offers the possibility of conservative surgery and is associated with high clinical and pathologic response rates, with promising and encouraging survival outcomes.

Keywords

Locally advanced breast cancer Neoadjuvant chemotherapy Anthracycline Cisplatin/docetaxel Pathologic complete response 

Notes

Acknowledgments

This work was supported by grant from King Faisal Specialist Hospital and Research Centre (RAC#2011-022). The authors thank the oncology data unit for their support during the preparation of this article.

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Copyright information

© Humana Press Inc. 2009

Authors and Affiliations

  • Taher A. Al-Tweigeri
    • 1
    Email author
  • Dahish S. Ajarim
    • 1
  • Adher A. Alsayed
    • 1
  • Mohamed M. Rahal
    • 1
  • Mohamed O. Alshabanah
    • 2
  • Asma M. Tulbah
    • 3
  • Osama A. Al-Malik
    • 4
  • Doha M. Fatani
    • 5
  • Gamal A. El-Husseiny
    • 2
  • Naser B. Elkum
    • 6
  • Adnan A. Ezzat
    • 1
  1. 1.Department of Medical OncologyKing Faisal Specialist Hospital and Research Centre, Oncology Centre, MBC 64RiyadhKingdom of Saudi Arabia
  2. 2.Department of Radiation OncologyKing Faisal Specialist Hospital and Research CentreRiyadhKingdom of Saudi Arabia
  3. 3.Department of PathologyKing Faisal Specialist Hospital and Research CentreRiyadhKingdom of Saudi Arabia
  4. 4.Department of SurgeryKing Faisal Specialist Hospital and Research CentreRiyadhKingdom of Saudi Arabia
  5. 5.Oncology Research UnitKing Faisal Specialist Hospital and Research CentreRiyadhKingdom of Saudi Arabia
  6. 6.Department of Biostatistics and Scientific ComputingKing Faisal Specialist Hospital and Research CentreRiyadhKingdom of Saudi Arabia

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