Published in:
01-01-2017 | Original Article
Docetaxel and cyclophosphamide as neoadjuvant chemotherapy in HER2-negative primary breast cancer
Authors:
Katsuhiko Nakatsukasa, Hiroshi Koyama, Yoshimi Oouchi, Seiichi Imanishi, Naruhiko Mizuta, Kouichi Sakaguchi, Yoshifumi Fujita, Ikuya Fujiwara, Tatsuya Kotani, Takayuki Matsuda, Kenichirou Fukuda, Midori Morita, Sadao Kawakami, Yayoi Kadotani, Eiichi Konishi, Akio Yanagisawa, Tetsuya Taguchi
Published in:
Breast Cancer
|
Issue 1/2017
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Abstract
Background
Docetaxel plus cyclophosphamide (TC) has recently been established as a standard adjuvant chemotherapy regimen for HER2-negative (HER2−) operable breast cancer. However, the efficacy and tolerability of TC as neoadjuvant chemotherapy (NAC) remain unclear. We, therefore, conducted a prospective study to evaluate the efficacy of TC NAC in HER2− primary breast cancer.
Methods
Patients who were diagnosed with HER2−, N0–N1, invasive breast cancer between July 2011 and February 2014 and had tumors measuring 1–7 cm were eligible. The subtypes were classified using a core-needle or vacuum-assisted breast biopsy. The efficacy and safety of NAC comprising TC (75 mg/m2 docetaxel and 600 mg/m2 cyclophosphamide, four cycles every 3 weeks) were investigated in a prospective study in patients with HER2− breast cancer.
Results
Fifty-two patients were enrolled. Of these, 94.2 % (49/52) completed four cycles of TC. The overall pCR rate was 16.3 % (8/49). The pCR rates for patients with luminal A-like breast cancer [estrogen receptor-positive (ER+), Ki67 index of <20 %, and HER2−], luminal B-like breast cancer (ER+, Ki67 index of >20 %, and HER2−), and triple-negative breast cancer [ER-negative (ER−) and HER2−] were 0 % (0/12), 4.3 % (1/23), and 50.0 % (7/14), respectively. Almost all pCRs occurred in triple-negative breast cancer patients.
Conclusions
The pCR rate of TC NAC was not very high despite the high completion rate. TC NAC was effective against the triple-negative subtype, resulting in a higher pCR rate. Therefore, our results indicated that TC NAC showed limited efficacy in luminal subtype breast cancer with the exception of the triple-negative subtype.