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Overview of preoperative radiochemotherapy in breast cancer: past or future?

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  • Current Technology in Cancer Research and Treatment
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Abstract

Radiochemotherapy is a standard approach in human solid tumours, with localised stage and radical treatment intention. In the early-intermediate stages of breast cancer model, neoadjuvant radiochemotherapy is an alternative to induction chemotherapy alone and might further impact the surgical technical treatment characteristics (a downsizing effect). In the era of targeted therapy and personalised treatment for breast cancer patients with initial localised disease, radiochemotherapy needs to be explored as a component of optimised local treatment to potentially improve relevant local results, such as breast conservation, breast cosmesis and individualised breast cancer radiochemotherapy response prediction. An overview of available literature data regarding neoadjuvant treatment including radiotherapy component is analysed and discussed.

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References

  1. Davila E, Vogel CL (1984) Management of locally advanced breast cancer (stage III): a review. Int Adv Surg Oncol 7:297–327

    PubMed  CAS  Google Scholar 

  2. Hortobagyi GN (1990) Comprehensive management of locally advanced breast cancer. Cancer 66:1387–1391

    Article  PubMed  CAS  Google Scholar 

  3. Zucali R, Uslenghi C, Kenda R et al (1976) Natural history and survival of inoperable breast cancer treated with radiotherapy and radiotherapy followed by radical mastectomy. Cancer 37:1422–1431

    Article  PubMed  CAS  Google Scholar 

  4. van der Hage JA, van de Velde CJ, Julien JP et al (2001) Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902. J Clin Oncol 19:4224–4237

    PubMed  Google Scholar 

  5. Harris EE, Schultz D, Bertsch H et al (2003) Tenyear outcome after combined modality therapy for inflammatory breast cancer. Int J Radiat Oncol Biol Phys 55:1200–1208

    Article  PubMed  Google Scholar 

  6. Bertucci F, Tarpin C, Charafe-Jauffret E et al (2004) Multivariate analysis of survival in inflammatory breast cancer: impact of intensity of chemotherapy in multimodality treatment. Bone Marrow Transplant 33:913–920

    Article  PubMed  CAS  Google Scholar 

  7. Viens P, Palangie T, Janvier M et al (1999) Firstline high-dose sequential chemotherapy with rGCSF and repeated blood stem cell transplantation in untreated inflammatory breast cancer: toxicity and response (PEGASE 02 trial). Br J Cancer 81:449–456

    Article  PubMed  CAS  Google Scholar 

  8. Veyret C, Levy C, Chollet P et al (2006) Inflammatory breast cancer outcome with epirubicin-based induction and maintenance chemotherapy: ten-year results from the French Adjuvant Study Group GETIS 02 Trial. Cancer 107:2535–2544

    Article  PubMed  CAS  Google Scholar 

  9. Damast S, Ho AY, Montgomery L et al (2010) Locoregional outcomes of inflammatory breast cancer patients treated with standard fractionation radiation and daily skin bolus in the taxane era. Int J Radiat Oncol Biol Phys 77:1105–1112

    Article  PubMed  Google Scholar 

  10. Hortobagyi GN, Ames FC, Buzdar AU et al (1988) Management of stage III primary breast cancer with primary chemotherapy, surgery, and radiation therapy. Cancer 62:2507–2516

    Article  PubMed  CAS  Google Scholar 

  11. Mauri D, Pavlidis N, Ioannidis JP (2005) Neoadjuvant versus adjuvant systemic treatment in breast cancer: a meta-analysis. J Natl Cancer Inst 97:188–194

    Article  PubMed  Google Scholar 

  12. Rastogi P, Anderson SJ, Bear HD et al (2008) Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27. J Clin Oncol 26:778–785

    Article  PubMed  Google Scholar 

  13. Wolmark N, Wang J, Mamounas E et al (2001) Preoperative chemotherapy in patients with operable breast cancer: nine-year results from National Surgical Adjuvant Breast and Bowel Project B-18. J Natl Cancer Inst Monogr 96–102

  14. Lingos TI, Recht A, Vicini F et al (1991) Radiation pneumonitis in breast cancer patients treated with conservative surgery and radiation therapy. Int J Radiat Oncol Biol Phys 21:355–360

    Article  PubMed  CAS  Google Scholar 

  15. Zambetti M, Moliterni A, Materazzo C et al (2001) Long-term cardiac sequelae in operable breast cancer patients given adjuvant chemotherapy with or without doxorubicin and breast irradiation. J Clin Oncol 19:37–43

    PubMed  CAS  Google Scholar 

  16. Bollet MA, Sigal-Zafrani B, Gambotti L et al (2006) Pathological response to preoperative concurrent chemo-radiotherapy for breast cancer: results of a phase II study. Eur J Cancer 42:2286–2295

    Article  PubMed  CAS  Google Scholar 

  17. Chakravarthy AB, Kelley MC, McLaren B et al (2006) Neoadjuvant concurrent paclitaxel and radiation in stage II/III breast cancer. Clin Cancer Res 12:1570–1576

    Article  PubMed  CAS  Google Scholar 

  18. Formenti SC, Volm M, Skinner KA et al (2003) Preoperative twice-weekly paclitaxel with concurrent radiation therapy followed by surgery and postoperative doxorubicin-based chemotherapy in locally advanced breast cancer: a phase I/II trial. J Clin Oncol 21:864–870

    Article  PubMed  CAS  Google Scholar 

  19. Vaughn CB, Chapman J, Chen SS et al (1988) Locally advanced adenocarcinoma of the breast without distant metastasis treated with multimodal therapies. Cancer Invest 6:467–474

    Article  PubMed  CAS  Google Scholar 

  20. Ueno NT, Buzdar AU, Singletary SE et al (1997) Combined-modality treatment of inflammatory breast carcinoma: twenty years of experience at M. D. Anderson Cancer Center. Cancer Chemother Pharmacol 40:321–329

    Article  PubMed  CAS  Google Scholar 

  21. Huang E, McNeese MD, Strom EA et al (2002) Locoregional treatment outcomes for inoperable anthracycline-resistant breast cancer. Int J Radiat Oncol Biol Phys 53:1225–1233

    Article  PubMed  Google Scholar 

  22. Gaui MF, Amorim G, Arcuri RA et al (2007) A phase II study of second-line neoadjuvant chemotherapy with capecitabine and radiation therapy for anthracycline-resistant locally advanced breast cancer. Am J Clin Oncol 30:78–81

    Article  PubMed  CAS  Google Scholar 

  23. Ghorbel I, Heymann S, Delaloge S et al (2010) Effect of preoperative concomitant chemoradiotherapy in chemotherapy-refractory breast cancer on feasibility of curative surgery and pathologic tumor response. J Clin Oncol 28:7s

    Article  Google Scholar 

  24. Chargari C, Kirova YM, Cottu P et al (2009) Progressive inflammatory breast cancer in patient receiving chemotherapy: the importance of radiotherapy as a part of locoregional treatment. Radiother Oncol 90:160–161

    Article  PubMed  Google Scholar 

  25. Mauriac L, MacGrogan G, Avril A et al (1999) Neoadjuvant chemotherapy for operable breast carcinoma larger than 3 cm: a unicentre randomized trial with a 124-month median follow-up. Institut Bergonie Bordeaux Groupe Sein (IBBGS). Ann Oncol 10:47–52

    Article  PubMed  CAS  Google Scholar 

  26. Broet P, Scholl SM, de la Rochefordiere A et al (1999) Short and long-term effects on survival in breast cancer patients treated by primary chemotherapy: an updated analysis of a randomized trial. Breast Cancer Res Treat 58:151–156

    Article  PubMed  CAS  Google Scholar 

  27. Kuerer HM, Newman LA, Smith TL et al (1999) Clinical course of breast cancer patients with complete pathologic primary tumor and axillary lymph node response to doxorubicin-based neoadjuvant chemotherapy. J Clin Oncol 17:460–469

    PubMed  CAS  Google Scholar 

  28. Bonadonna G, Valagussa P, Brambilla C et al (1998) Primary chemotherapy in operable breast cancer: eight-year experience at the Milan Cancer Institute. J Clin Oncol 16:93–100

    PubMed  CAS  Google Scholar 

  29. Fisher B, Bryant J, Wolmark N et al (1998) Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. J Clin Oncol 16:2672–2685

    PubMed  CAS  Google Scholar 

  30. Jones RL, Lakhani SR, Ring AE et al (2006) Pathological complete response and residual DCIS following neoadjuvant chemotherapy for breast carcinoma. Br J Cancer 94:358–362

    Article  PubMed  CAS  Google Scholar 

  31. Thoms WW Jr, McNeese MD, Fletcher GH et al (1989) Multimodal treatment for inflammatory breast cancer. Int J Radiat Oncol Biol Phys 17:739–745

    Article  PubMed  Google Scholar 

  32. Bristol IJ, Woodward WA, Strom EA et al (2008) Locoregional treatment outcomes after multimodality management of inflammatory breast cancer. Int J Radiat Oncol Biol Phys 72:474–484

    Article  PubMed  Google Scholar 

  33. Mourali N, Tabbane F, Muenz LR et al (1993) Ten-year results utilizing chemotherapy as primary treatment in nonmetastatic, rapidly progressing breast cancer. Cancer Invest 11:363–370

    Article  PubMed  CAS  Google Scholar 

  34. Pessoa E, Dunant A, Heymann S et al (2010) Twenty-year results of alternating radiotherapy and chemotherapy in nonmetastatic inflammatory breast cancer. J Clin Oncol 28:638

    Google Scholar 

  35. Rouesse J, Friedman S, Sarrazin D et al (1986) Primary chemotherapy in the treatment of inflammatory breast carcinoma: a study of 230 cases from the Institut Gustave-Roussy. J Clin Oncol 4: 1765–1771

    PubMed  CAS  Google Scholar 

  36. Buzdar AU, Singletary SE, Theriault RL et al (1999) Prospective evaluation of paclitaxel versus combination chemotherapy with fluorouracil, doxorubicin, and cyclophosphamide as neoadjuvant therapy in patients with operable breast cancer. J Clin Oncol 17:3412–3417

    PubMed  CAS  Google Scholar 

  37. Swain SM, Sorace RA, Bagley CS et al (1987) Neoadjuvant chemotherapy in the combined modality approach of locally advanced nonmetastatic breast cancer. Cancer Res 47:3889–3894

    PubMed  CAS  Google Scholar 

  38. Karlsson YA, Malmstrom PO, Hatschek T et al (1998) Multimodality treatment of 128 patients with locally advanced breast carcinoma in the era of mammography screening using standard polychemotherapy with 5-fluorouracil, epirubicin, and cyclophosphamide: prognostic and therapeutic implications. Cancer 83:936–947

    Article  PubMed  CAS  Google Scholar 

  39. Formenti SC, Symmans WF, Volm M et al (1999) Concurrent paclitaxel and radiation therapy for breast cancer. Semin Radiat Oncol 9:34–42

    PubMed  CAS  Google Scholar 

  40. Jordan MA, Thrower D, Wilson L (1991) Mechanism of inhibition of cell proliferation by vinca alkaloids. Cancer Res 51:2212–2222

    PubMed  CAS  Google Scholar 

  41. Wilson L, Panda D, Jordan MA (1999) Modulation of microtubule dynamics by drugs: a paradigm for the actions of cellular regulators. Cell Struct Funct 24:329–335

    Article  PubMed  CAS  Google Scholar 

  42. Edelstein MP, Wolfe LA 3rd, Duch DS (1996) Potentiation of radiation therapy by vinorelbine (Navelbine) in non-small cell lung cancer. Semin Oncol 23:41–47

    PubMed  CAS  Google Scholar 

  43. Gridelli C, Guida C, Barletta E et al (2000) Thoracic radiotherapy and daily vinorelbine as radiosensitizer in locally advanced non small cell lung cancer: a phase I study. Lung Cancer 29:131–137

    Article  PubMed  CAS  Google Scholar 

  44. Geh JI (2002) The use of chemoradiotherapy in oesophageal cancer. Eur J Cancer 38:300–313

    Article  PubMed  CAS  Google Scholar 

  45. Pignon JP, Bourhis J, Domenge C et al (2000) Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACHNC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer. Lancet 355:949–955

    PubMed  CAS  Google Scholar 

  46. Rose PG (2002) Chemoradiotherapy for cervical cancer. Eur J Cancer 38:270–278

    Article  PubMed  CAS  Google Scholar 

  47. Simoens C, Lardon F, Pauwels B et al (2008) Comparative study of the radiosensitizing and cell cycle effects of vinflunine and vinorelbine, in vitro. BMC Cancer 8:65

    Article  PubMed  Google Scholar 

  48. Pinedo HM, Peters GF (1988) Fluorouracil: biochemistry and pharmacology. J Clin Oncol 6: 1653–1664

    PubMed  CAS  Google Scholar 

  49. Byfield JE, Calabro-Jones P, Klisak I et al (1982) Pharmacologic requirements for obtaining sensitization of human tumor cells in vitro to combined 5-fluorouracil or ftorafur and X rays. Int J Radiat Oncol Biol Phys 8:1923–1933

    Article  PubMed  CAS  Google Scholar 

  50. Rich TA, Shepard RC, Mosley ST (2004) Four decades of continuing innovation with fluorouracil: current and future approaches to fluorouracil chemoradiation therapy. J Clin Oncol 22:2214–2232

    Article  PubMed  CAS  Google Scholar 

  51. Bruso CE, Shewach DS, Lawrence TS (1990) Fluorodeoxyuridine-induced radiosensitization and inhibition of DNA double strand break repair in human colon cancer cells. Int J Radiat Oncol Biol Phys 19:1411–1417

    Article  PubMed  CAS  Google Scholar 

  52. McGinn CJ, Shewach DS, Lawrence TS (1996) Radiosensitizing nucleosides. J Natl Cancer Inst 88:1193–1203

    Article  PubMed  CAS  Google Scholar 

  53. Yarden Y, Sliwkowski MX (2001) Untangling the ErbB signalling network. Nat Rev Mol Cell Biol 2:127–137

    Article  PubMed  CAS  Google Scholar 

  54. Nielsen TO, Hsu FD, Jensen K et al (2004) Immunohistochemical and clinical characterization of the basal-like subtype of invasive breast carcinoma. Clin Cancer Res 10:5367–5374

    Article  PubMed  CAS  Google Scholar 

  55. Harari PM, Huang SM (2001) Radiation response modification following molecular inhibition of epidermal growth factor receptor signaling. Semin Radiat Oncol 11:281–289

    Article  PubMed  CAS  Google Scholar 

  56. Bianco C, Tortora G, Bianco R et al (2002) Enhancement of antitumor activity of ionizing radiation by combined treatment with the selective epidermal growth factor receptor-tyrosine kinase inhibitor ZD1839 (Iressa). Clin Cancer Res 8:3250–3258

    PubMed  CAS  Google Scholar 

  57. She Y, Lee F, Chen J et al (2003) The epidermal growth factor receptor tyrosine kinase inhibitor ZD1839 selectively potentiates radiation response of human tumors in nude mice, with a marked improvement in therapeutic index. Clin Cancer Res 9:3773–3778

    PubMed  CAS  Google Scholar 

  58. Nguyen PL, Taghian AG, Katz MS et al (2008) Breast cancer subtype approximated by estrogen receptor, progesterone receptor, and HER-2 is associated with local and distant recurrence after breast-conserving therapy. J Clin Oncol 26:2373–2378

    Article  PubMed  Google Scholar 

  59. Pietras RJ, Poen JC, Gallardo D et al (1999) Monoclonal antibody to HER-2/neureceptor modulates repair of radiation-induced DNA damage and enhances radiosensitivity of human breast cancer cells overexpressing this oncogene. Cancer Res 59:1347–1355

    PubMed  CAS  Google Scholar 

  60. Liang K, Lu Y, Jin W et al (2003) Sensitization of breast cancer cells to radiation by trastuzumab. Mol Cancer Ther 2:1113–1120

    PubMed  CAS  Google Scholar 

  61. Horton JK, Halle J, Ferraro M et al (2010) Radiosensitization of chemotherapy-refractory, locally advanced or locally recurrent breast cancer with trastuzumab: a phase II trial. Int J Radiat Oncol Biol Phys 76:998–1004

    Article  PubMed  CAS  Google Scholar 

  62. Sambade MJ, Camp JT, Kimple RJ et al (2009) Mechanism of lapatinib-mediated radiosensitization of breast cancer cells is primarily by inhibition of the Raf>MEK>ERK mitogen-activated protein kinase cascade and radiosensitization of lapatinib-resistant cells restored by direct inhibition of MEK. Radiother Oncol 93:639–644

    Article  PubMed  CAS  Google Scholar 

  63. Sambade MJ, Kimple RJ, Camp JT et al (2010) Lapatinib in combination with radiation diminishes tumor regrowth in HER2+ and basal-like/ EGFR+ breast tumor xenografts. Int J Radiat Oncol Biol Phys 77:575–581

    Article  PubMed  CAS  Google Scholar 

  64. Zhou H, Kim YS, Peletier A et al (2004) Effects of the EGFR/HER2 kinase inhibitor GW572016 on EGFR- and HER2-overexpressing breast cancer cell line proliferation, radiosensitization, and resistance. Int J Radiat Oncol Biol Phys 58:344–352

    Article  PubMed  CAS  Google Scholar 

  65. Sofia Vala I, Martins LR, Imaizumi N et al (2010) Low doses of ionizing radiation promote tumor growth and metastasis by enhancing angiogenesis. PLoS One 5:e11222

    Article  PubMed  Google Scholar 

  66. Goyal S, Rao MS, Khan A et al (2011) Evaluation of acute locoregional toxicity in patients with breast cancer treated with adjuvant radiotherapy in combination with bevacizumab. Int J Radiat Oncol Biol Phys 79:408–413

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Breast Cancer Unit Radiation Oncology Department, Institute Gustave Roussy, Paris, France

    Céline Bourgier

  2. Department of Oncology, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo, 46, ES-28007, Madrid, Spain

    Felipe A. Calvo

  3. Radiation Oncology Department, Instituto Madrileño de Oncología, Madrid, Spain

    Hugo Marsiglia

  4. Radiation Oncology Department, Institute Gustave Roussy, Paris, France

    Hugo Marsiglia

  5. Medical Oncology Service, Hospital General Universitario Gregorio Marañón, Madrid, Spain

    Miguel Martín

Authors
  1. Céline Bourgier
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  2. Felipe A. Calvo
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  3. Hugo Marsiglia
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  4. Miguel Martín
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Correspondence to Felipe A. Calvo.

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Bourgier, C., Calvo, F.A., Marsiglia, H. et al. Overview of preoperative radiochemotherapy in breast cancer: past or future?. Clin Transl Oncol 13, 446–450 (2011). https://doi.org/10.1007/s12094-011-0681-2

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  • DOI: https://doi.org/10.1007/s12094-011-0681-2

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