Original Article · Originalarbeit

Increased Feasibility of Weekly Epirubicin and Paclitaxel as Neoadjuvant Chemotherapy for Locally Advanced Breast Carcinoma
S.C. Chen^a; H.K. Chang^b; Y.C. Lin^b; Y.C. Cheung^c; C.S. Tsai^d; W.M. Leung^d; S. Hsueh^e; M.F. Chen^a

^aDepartment of Surgery, ^bDivision of Medical Oncology, ^cDepartment of Diagnostic Radiology, ^dDepartment of Radiation Oncology, ^eDepartment of Pathology, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan, Taiwan

Onkologie 2005;28:339-344
(DOI: 10.1159/000085414)

  Summary

Background: Primary systemic therapy (PST) with a combination of epirubicin and paclitaxel achieves high response rates in locally advanced breast cancer (LABC), but considerable toxicity occurs and the patient’s compliance is poor. In this open-label phase II trial toxicitiy of a weekly administration schedule was evaluated. Patients and Methods: On days 1 and 8 of each 3-week cycle, 45 patients with non-inflammatory breast cancer received epirubicin (35 mg/m2, intravenous bolus) followed by paclitaxel (80 mg/m2 in 500 ml of normal saline infused over 3 h) for 3 cycles. Surgery was done 2 weeks after primary chemotherapy, followed by another 6 cycles of adjuvant CEF (cyclophosphamide 500 mg/m2, epirubicin 70 mg/m2, 5-fluorouracil 500 mg/m2) chemotherapy. Results: The median tumor size before and after PST was 6.0 and 2.0 cm, respectively. The clinical response rate was 96%, including 24% complete remission; 5 patients (11%) achieved pathologically complete response (pCR) including 3 patients with carcinoma in situ. Only 5 (11%) patients underwent breast conserving surgery although there were 15 patients suitable. Axillary nodes were negative in 16 (36%) of the 45 patients. Febrile neutropenia was found in 1 patient. There was no severe cardiac toxicity or serious adverse events. Conclusions: PST with weekly epirubicin and paclitaxel was an effective and well-tolerated combination for LABC, although only few patients underwent breast conserving surgery.

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