Neoadjuvant docetaxel for operable breast cancer induces a high pathological response and breast-conservation rate.

Abstract

Docetaxel (Taxotere), alone or in combination with other anticancer agents, has proven efficacy in the first- and second-line treatment of metastatic breast cancer. This phase II study investigated the efficacy and tolerability of docetaxel as neoadjuvant chemotherapy in women with stage II-III primary operable breast cancer. Patients (n=88) were treated with six cycles of docetaxel at 100 mg m(-2) every 21 days, followed by definitive surgery and radiotherapy. After six cycles of docetaxel, the overall clinical response rate was 68.4% (CI 95%: 58.1-78.7%), including 19.0% complete remissions. Breast conservation was achieved in 72.4% of patients. A high pathological complete response (pCR) rate in breast was confirmed in 15 patients (19.8% (CI 95%: 10.8-28.8%)) on Chevallier's classification restricted to breast and in 27 patients (35.5% (CI 95%: 24.7-46.3%)) on Sataloff's classification. After a median follow-up of 30.8 months, 19 recurrences were documented with a median time to first recurrence of 17.3 months. Patients with stage III tumours had more recurrences than patients with stage II tumours (P=0.02). The principal toxicity of docetaxel is myelosuppression and 70.5% of patients developed grade III or IV neutropenia with 13.6% developing neutropenic sepsis. There was no case of severe cardiac toxicity, thrombocytopenia or any other serious adverse events. In conclusion, neoadjuvant docetaxel induces a high pCR and breast-conservation rate. Docetaxel monotherapy is a highly effective regimen that merits formal comparison with currently used combination regimens in a randomised phase III study.

• Authors: S Amat, P Bougnoux, F Penault-Llorca, F Fétissof, H Curé, F Kwiatkowski, J-L Achard, G Body, J Dauplat, P Chollet
• Journal: British journal of cancer (Br J Cancer) Vol. 88 Issue 9 Pg. 1339-45 (May 6 2003) ISSN: 0007-0920 [Print] England
• PMID: 12778058 (Publication Type: Clinical Trial, Clinical Trial, Phase II, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Antineoplastic Agents, Phytogenic
• Receptors, Estrogen
• Receptors, Progesterone
• Taxoids
• docetaxel
• Paclitaxel
• Methylprednisolone

Topics

• Antineoplastic Agents, Phytogenic (administration & dosage, adverse effects, therapeutic use)
• Blood Cell Count
• Breast Neoplasms (drug therapy, mortality, pathology, radiotherapy, surgery)
• Chemotherapy, Adjuvant
• Drug Administration Schedule
• Female
• Humans
• Injections, Intravenous
• Methylprednisolone (therapeutic use)
• Neoplasm Invasiveness
• Neoplasm Staging
• Paclitaxel (administration & dosage, adverse effects, analogs & derivatives, therapeutic use)
• Receptors, Estrogen (analysis)
• Receptors, Progesterone (analysis)
• Recurrence
• Survival Analysis
• Taxoids
• Treatment Outcome