OBJECTIVES: Preoperative chemotherapy produces tumor shrinkage in most patients with locally advanced breast cancer, including some pathological complete responses (pCRs). We attempted this using a much less toxic sequential regimen, given with concurrent bevacizumab. METHODS: Patients with locally advanced breast cancer received 3 intravenous doses each of preoperative sequential liposome encapsulated doxorubicin 25 mg/m2, paclitaxel 175 mg/m2, and cyclophosphamide 600 mg/m2, with concurrent bevacizumab every 2 weeks without growth factor support. RESULTS: Between March 2008 and December 2009, 32 patients received treatment. There was no cardiotoxicity, and other toxicity was mild (no grade 4 or 5 toxicity). No long-term toxicity, including cardiotoxicity, has been observed. Every patient had ≥30% reduction in tumor size; 9 of 31 patients who completed chemotherapy had pCR at operation. Seven years later, 22 of 32 patients remain free of recurrence and 27 of 32 are alive. CONCLUSIONS: The preoperative chemotherapy used appears to be comparably effective, but much less toxic than that used in most conventional regimens and should be studied further. Concurrent treatment with bevacizumab (reported separately) did not provide any additional benefit.
OBJECTIVES: Preoperative chemotherapy produces tumor shrinkage in most patients with locally advanced breast cancer, including some pathological complete responses (pCRs). We attempted this using a much less toxic sequential regimen, given with concurrent bevacizumab. METHODS: Patients with locally advanced breast cancer received 3 intravenous doses each of preoperative sequential liposome encapsulated doxorubicin 25 mg/m2, paclitaxel 175 mg/m2, and cyclophosphamide 600 mg/m2, with concurrent bevacizumab every 2 weeks without growth factor support. RESULTS: Between March 2008 and December 2009, 32 patients received treatment. There was no cardiotoxicity, and other toxicity was mild (no grade 4 or 5 toxicity). No long-term toxicity, including cardiotoxicity, has been observed. Every patient had ≥30% reduction in tumor size; 9 of 31 patients who completed chemotherapy had pCR at operation. Seven years later, 22 of 32 patients remain free of recurrence and 27 of 32 are alive. CONCLUSIONS: The preoperative chemotherapy used appears to be comparably effective, but much less toxic than that used in most conventional regimens and should be studied further. Concurrent treatment with bevacizumab (reported separately) did not provide any additional benefit.
Authors: C Hudis; A Seidman; J Baselga; G Raptis; D Lebwohl; T Gilewski; M Moynahan; N Sklarin; D Fennelly; J P Crown; A Surbone; M Uhlenhopp; E Riedel; T J Yao; L Norton Journal: J Clin Oncol Date: 1999-01 Impact factor: 44.544
Authors: B Fisher; A Brown; E Mamounas; S Wieand; A Robidoux; R G Margolese; A B Cruz; E R Fisher; D L Wickerham; N Wolmark; A DeCillis; J L Hoehn; A W Lees; N V Dimitrov Journal: J Clin Oncol Date: 1997-07 Impact factor: 44.544
Authors: Patricia Cortazar; Lijun Zhang; Michael Untch; Keyur Mehta; Joseph P Costantino; Norman Wolmark; Hervé Bonnefoi; David Cameron; Luca Gianni; Pinuccia Valagussa; Sandra M Swain; Tatiana Prowell; Sibylle Loibl; D Lawrence Wickerham; Jan Bogaerts; Jose Baselga; Charles Perou; Gideon Blumenthal; Jens Blohmer; Eleftherios P Mamounas; Jonas Bergh; Vladimir Semiglazov; Robert Justice; Holger Eidtmann; Soonmyung Paik; Martine Piccart; Rajeshwari Sridhara; Peter A Fasching; Leen Slaets; Shenghui Tang; Bernd Gerber; Charles E Geyer; Richard Pazdur; Nina Ditsch; Priya Rastogi; Wolfgang Eiermann; Gunter von Minckwitz Journal: Lancet Date: 2014-02-14 Impact factor: 79.321
Authors: M E R O'Brien; N Wigler; M Inbar; R Rosso; E Grischke; A Santoro; R Catane; D G Kieback; P Tomczak; S P Ackland; F Orlandi; L Mellars; L Alland; C Tendler Journal: Ann Oncol Date: 2004-03 Impact factor: 32.976
Authors: Edith A Perez; Vera J Suman; Nancy E Davidson; Peter A Kaufman; Silvana Martino; Shaker R Dakhil; James N Ingle; Richard J Rodeheffer; Bernard J Gersh; Allan S Jaffe Journal: J Clin Oncol Date: 2004-09-15 Impact factor: 44.544
Authors: I Craig Henderson; Donald A Berry; George D Demetri; Constance T Cirrincione; Lori J Goldstein; Silvana Martino; James N Ingle; M Robert Cooper; Daniel F Hayes; Katherine H Tkaczuk; Gini Fleming; James F Holland; David B Duggan; John T Carpenter; Emil Frei; Richard L Schilsky; William C Wood; Hyman B Muss; Larry Norton Journal: J Clin Oncol Date: 2003-03-15 Impact factor: 44.544
Authors: Eric P Winer; Donald A Berry; Susan Woolf; David Duggan; Alice Kornblith; Lyndsay N Harris; Richard A Michaelson; Jeffrey A Kirshner; Gini F Fleming; Michael C Perry; Mark L Graham; Stewart A Sharp; Roger Keresztes; I Craig Henderson; Clifford Hudis; Hyman Muss; Larry Norton Journal: J Clin Oncol Date: 2004-06-01 Impact factor: 44.544