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Medline ® Abstract for Reference 35

of 'General principles of neoadjuvant therapy for breast cancer'

Docetaxel and cyclophosphamide as neoadjuvant chemotherapy in HER2-negative primary breast cancer.
Nakatsukasa K, Koyama H, Oouchi Y, Imanishi S, Mizuta N, Sakaguchi K, Fujita Y, Fujiwara I, Kotani T, Matsuda T, Fukuda K, Morita M, Kawakami S, Kadotani Y, Konishi E, Yanagisawa A, Taguchi T
Breast Cancer. 2017;24(1):63. Epub 2016 Jan 11.
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/m(2) docetaxel and 600 mg/m(2) 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.
Department of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. kacchan@koto.kpu-m.ac.jp.