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Nonanthracycline Combination Shows Promise as Neoadjuvant Therapy for Breast Cancer

Nonanthracycline Combination Shows Promise as Neoadjuvant Therapy for Breast Cancer

MIAMI—As neoadjuvant therapy for breast cancer, docetaxel (Taxotere) plus
cisplatin delivers pathologic complete response rates as good or better than
standard anthracycline-containing regimens, results of a nonrandomized study
suggest. The study involved 57 patients with locally advanced and inflammatory
breast cancer.

The pathologic complete response rate of 27% in this trial "is very
unusual," considering the large median tumor size (9 cm, range 4 to 37 cm) and
inclusion of women with inoperable breast cancer (about 50% of the patients)
and inflammatory disease (about 25% of the patients), according to Young Lee,
MD, of the Sylvester Cancer Center, University of Miami.

The favorable rate may be due to synergistic activity between platinums and
taxanes, Dr. Lee noted. In previous studies, docetaxel alone produced a
pathologic complete response of only about 7%.

‘Very Good’ Survival

Investigators treated 57 black, Latin, and Caribbean women. The median age
was 49 and 53% of the women were premenopausal. Patients received cisplatin 70
mg/m2 and docetaxel 70 mg/m2, with G-CSF prophylaxis,
every 21 days for four cycles. This was followed by surgery, then adjuvant
doxorubicin/cyclophosphamide (Cytoxan, Neosar) for four cycles, and radiation
therapy. Women who were estrogen receptor-positive (20 of 56 evaluable
patients, or 36%) received 20 mg tamoxifen daily.

Pathologic complete response in the breast to neoadjuvant treatment was seen
in 15 of 56 evaluable patients (27%); 11 patients (20%) had pathologic complete
response in both breast and axilla.

Overall survival at 3 years was 78%, and disease-free survival was 69%, both
considered "very good" in this high-risk group. Overall survival was 92% for
women who had a pathologic complete response in the breast and 74% for women
who did not.


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