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Kiba T, Morii N, Takahashi H, et al. Pathological complete response rate in hormone receptor-negative breast cancer treated with neoadjuvant FEC, followed by weekly paclitaxel administration: A retrospective study and review of the literature. Oncol Lett. 2016;11(5):3064-3070doi: 10.3892/ol.2016.4334.
Kiba, T., Morii, N., Takahashi, H., Ozaki, S., Atsumi, M., Masumoto, F., & Yamashiro, H. (2016). Pathological complete response rate in hormone receptor-negative breast cancer treated with neoadjuvant FEC, followed by weekly paclitaxel administration: A retrospective study and review of the literature. Oncology letters, 11(5), 3064-3070. https://doi.org/10.3892/ol.2016.4334
Kiba, Takayoshi, et al. "Pathological complete response rate in hormone receptor-negative breast cancer treated with neoadjuvant FEC, followed by weekly paclitaxel administration: A retrospective study and review of the literature." Oncology letters vol. 11,5 (2016): 3064-3070. doi: https://doi.org/10.3892/ol.2016.4334
Kiba T, Morii N, Takahashi H, Ozaki S, Atsumi M, Masumoto F, Yamashiro H. Pathological complete response rate in hormone receptor-negative breast cancer treated with neoadjuvant FEC, followed by weekly paclitaxel administration: A retrospective study and review of the literature. Oncol Lett. 2016 May;11(5):3064-3070. doi: 10.3892/ol.2016.4334. Epub 2016 Mar 16. PMID: 27123064; PMCID: PMC4841046.
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Oncol Lett. 2016 May;11(5):3064-3070. doi: 10.3892/ol.2016.4334. Epub 2016 Mar 16.

Pathological complete response rate in hormone receptor-negative breast cancer treated with neoadjuvant FEC, followed by weekly paclitaxel administration: A retrospective study and review of the literature.

Oncology letters

Takayoshi Kiba, Nao Morii, Hirotoshi Takahashi, Shinji Ozaki, Misao Atsumi, Fumi Masumoto, Hiroyasu Yamashiro

Affiliations

  1. Division of Modern Medical Technology, Institute for Clinical Research, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima 737-0023, Japan; Department of Clinical Oncology, Tohoku Pharmaceutical University Hospital, Sendai, Miyagi 983-8512, Japan.
  2. Department of Breast Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima 737-0023, Japan.
  3. Clinical Trial Management Office, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima 737-0023, Japan.
  4. Department of Breast Surgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima 737-0023, Japan; Department of Breast Surgery, Tenri Hospital, Tenri, Nara 632-8552, Japan.

PMID: 27123064 PMCID: PMC4841046 DOI: 10.3892/ol.2016.4334

Abstract

While tumor size, the presence of inflammatory carcinoma and lymph node involvement are the main prognostic factors of women with locally advanced breast cancer, the prognostic value of the estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 (HER2) status has not been fully clarified. The present study examined the therapeutic efficacy of a neoadjuvant fluorouracil, epirubicin and cyclophosphamide regimen (FEC), followed by weekly paclitaxel and/or trastuzumab administration, in the treatment of hormone receptor-negative breast cancer patients. Between April 2012 and February 2014, 14 patients with hormone receptor-negative local breast cancer (triple-negative type, 9 patients; HER2 type, 5 patients) were included in the study. In all cases, the histological type of the primary cancer was invasive ductal carcinoma. Among the 14 women who received the regimen, 5 presented with stage I cancer (35.7%), 3 with stage IIA (21.4%), 3 with stage IIB (21.4%), 1 with stage IIIB (7.1%) and 2 with stage IIIC (14.3%), according to the American Joint Committee on Cancer staging system. With regard to the tumor-node-metastasis classification, 5 patients were T1N0M0 (35.7%), 3 were T2N0M0 (21.4%), 3 were T2N1M0 (21.4%), 2 were T3N3M0 (14.3%) and 1 was T4N1M0 (7.1%). The pathological response was evaluated using resected tissue following neoadjuvant chemotherapy, according to the criteria established by the Japanese Breast Cancer Society. Patients were classified into pathological responders (grades 2 and 3, 71.4% of all patients) and non-responders (grade 1, 28.6% of all patients). A pathological complete response (pCR) was achieved in 50.0% of all cases (7/14); 44.4% of triple-negative-type cases (4/9) and 60.0% of HER2-type cases (3/5). Hematological and non-hematological toxicity was reversible and manageable. No patients withdrew from treatment, and favorable compliance was achieved. The present study demonstrated that neoadjuvant FEC followed by weekly administration of paclitaxel and/or trastuzumab induces a high pathological response and a high pCR rate in patients with hormone receptor-negative breast cancer. Due to the high clinical benefit rate and acceptable safety profile, this regimen should be considered an acceptable neoadjuvant treatment option for hormone receptor-negative breast cancer.

Keywords: breast cancer; epirubicin and cyclophosphamide regimen; fluorouracil; paclitaxel; pathological complete response

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