PURPOSE: To improve treatment outcome for patients presenting with inflammatory breast cancer (IBC), we have sequentially developed and tested single and tandem dose-intense chemotherapy regimens (DICT). Tumor- and treatment-related factors were analyzed to generate a prognostic model. PATIENTS AND METHODS: Between May 1989 and April 2002, 120 patients receivedconventional-dose chemotherapy, surgery, and sequentially developed single- or tandem-cycle DICT. Disease- and treatment-specific features were subjected to univariate and multivariate analysis to correlate with outcome. RESULTS: At a median follow-up of 61 months (range, 21 to 161 months), estimated 5-year relapse-free survival (RFS) and overall survival (OS) were 44% (95% CI, 34% to 53%) and 64% (95% CI, 55% to 73%), respectively. In an age-adjusted multivariate analysis, RFS was better in patients with estrogen receptor (ER)/progesterone receptor (PR)-positive tumors (P =.002), for patients with fewer than four involved axillary nodes before DICT (P =.01), and in patients treated with radiation therapy (P =.001) and tandem DICT (P =.049). OS was improved in patients with ER/PR-positive tumors (P =.002), in those with fewer than four involved axillary nodes before DICT (P =.03), and in patients treated with radiation therapy (P =.002). CONCLUSION: This retrospective analysis suggests that either single or tandem DICT can be administered safely and may benefit selected patients with stage IIIB IBC. Those with receptor-negative IBC and with four or more involved axillary nodes before DICT need improved neoadjuvant and postadjuvant intensification therapy. A prospective randomized trial of single versus tandem DICT would be required to confirm the potential benefit of tandem DICT in the setting of IBC.
RCT Entities:
PURPOSE: To improve treatment outcome for patients presenting with inflammatory breast cancer (IBC), we have sequentially developed and tested single and tandem dose-intense chemotherapy regimens (DICT). Tumor- and treatment-related factors were analyzed to generate a prognostic model. PATIENTS AND METHODS: Between May 1989 and April 2002, 120 patients received conventional-dose chemotherapy, surgery, and sequentially developed single- or tandem-cycle DICT. Disease- and treatment-specific features were subjected to univariate and multivariate analysis to correlate with outcome. RESULTS: At a median follow-up of 61 months (range, 21 to 161 months), estimated 5-year relapse-free survival (RFS) and overall survival (OS) were 44% (95% CI, 34% to 53%) and 64% (95% CI, 55% to 73%), respectively. In an age-adjusted multivariate analysis, RFS was better in patients with estrogen receptor (ER)/progesterone receptor (PR)-positive tumors (P =.002), for patients with fewer than four involved axillary nodes before DICT (P =.01), and in patients treated with radiation therapy (P =.001) and tandem DICT (P =.049). OS was improved in patients with ER/PR-positive tumors (P =.002), in those with fewer than four involved axillary nodes before DICT (P =.03), and in patients treated with radiation therapy (P =.002). CONCLUSION: This retrospective analysis suggests that either single or tandem DICT can be administered safely and may benefit selected patients with stage IIIB IBC. Those with receptor-negative IBC and with four or more involved axillary nodes before DICT need improved neoadjuvant and postadjuvant intensification therapy. A prospective randomized trial of single versus tandem DICT would be required to confirm the potential benefit of tandem DICT in the setting of IBC.
Authors: A VanderWalde; W Ye; P Frankel; D Asuncion; L Leong; T Luu; R Morgan; P Twardowski; M Koczywas; R Pezner; I B Paz; K Margolin; J Wong; J H Doroshow; S Forman; S Shibata; G Somlo Journal: Biol Blood Marrow Transplant Date: 2012-02-02 Impact factor: 5.742
Authors: Kenneth W Hance; William F Anderson; Susan S Devesa; Heather A Young; Paul H Levine Journal: J Natl Cancer Inst Date: 2005-07-06 Impact factor: 13.506
Authors: Laurys Boudin; Anthony Gonçalves; Patrick Sfumato; Renaud Sabatier; François Bertucci; Carole Tarpin; Magali Provansal; Gilles Houvenaeghel; Eric Lambaudie; Agnes Tallet; Michel Resbeut; Emmanuelle Charafe-Jauffret; Boris Calmels; Claude Lemarie; Jean-Marie Boher; Jean-Marc Extra; Patrice Viens; Christian Chabannon Journal: J Cancer Date: 2016-10-23 Impact factor: 4.207
Authors: D Genet; C Lejeune; P Bonnier; Y Aubard; L Venat-Bouvet; D J Adjadj; J Martin; J L Labourey; A Benyoub; P Clavère; V Lebrun-Ly; P Juin; L Piana; N Tubiana-Mathieu Journal: Br J Cancer Date: 2007-09-18 Impact factor: 7.640