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Medical Oncology

, 32:184 | Cite as

Lymphatic-targeted therapy following neoadjuvant chemotherapy: a promising strategy for lymph node-positive breast cancer treatment

  • Jianghao ChenEmail author
  • Qing Yao
  • Hui Wang
  • Bo Wang
  • Juliang Zhang
  • Ting Wang
  • Yonggang Lv
  • Zenghui Han
  • Ling WangEmail author
Article

Abstract

Neoadjuvant chemotherapy has been increasingly used to downstage breast cancer prior to surgery recently. However, in some cases, it was observed that despite sufficient regression of primary tumors, the metastatic lymph nodes remained nonresponsive. In this study, we applied lymphatic-targeted strategy to evaluate its efficacy and safety for patients presenting refractory nodes following systemic chemotherapy. A total of 318 breast cancer patients were demonstrated with lymph node metastasis by needle biopsy and given neoadjuvant chemotherapy. Two cycles later, 72 patients were observed with responsive tumors but stable nodes, 42 of which received a subcutaneous injection of lymphatic-targeted pegylated liposomal doxorubicin during the third cycle, while the remaining 30 patients were continued with former neoadjuvant therapeutic pattern and regarded as the control. Lymphatic-targeted treatment substantially increased both clinical and pathological node response rate [62 % (26/42) vs. 13 % (4/30) and 12 % (5/42) vs. 0 (0/30), respectively], and induced a higher apoptosis level of metastatic cells (median, 41 vs. 6 %), compared with the control. Moreover, a higher disease-free survival was observed after a median follow-up of 4 years (69 vs. 56 %). Inflammatory reaction surrounding injection sites was the most common side effect. Lymphatic chemotherapy has reliable efficacy and well-tolerated toxicity for breast cancer patients presenting refractory lymph nodes following neoadjuvant chemotherapy.

Keywords

Breast cancer Neoadjuvant chemotherapy Lymph node metastasis Lymphatic-targeting chemotherapy 

Notes

Acknowledgments

This work was supported by Grants provided by National Natural Science Foundation of China (No. 81172510, JC; No. 81272899, LW) and Natural Science Foundation of Shaanxi Province (No. 2011K12-45, JC; No. 2012K13-02-28, QY).

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Jianghao Chen
    • 1
    • 4
    Email author
  • Qing Yao
    • 1
  • Hui Wang
    • 1
  • Bo Wang
    • 2
  • Juliang Zhang
    • 1
  • Ting Wang
    • 1
  • Yonggang Lv
    • 1
  • Zenghui Han
    • 3
  • Ling Wang
    • 1
    • 4
    Email author
  1. 1.Department of Thyroid, Breast and Vascular Surgery, Xijing HospitalThe Fourth Military Medical UniversityXi’anChina
  2. 2.Department of EpidemiologyThe Fourth Military Medical UniversityXi’anChina
  3. 3.Department of Ultrasound, Xijing HospitalThe Fourth Military Medical UniversityXi’anChina
  4. 4.Department of Vascular and Endocrine Surgery, Xijing HospitalThe Fourth Military Medical UniversityXi’anChina

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