Original Contribution| Volume 5, ISSUE 5, P371-376, December 2004

Docetaxel and Cisplatin as Primary Chemotherapy for Treatment of Locally Advanced Breast Cancers

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      A phase II trial was designed to evaluate the effectiveness of docetaxel/cisplatin as primary or neoadjuvant chemotherapy of locally advanced breast carcinoma (LABC). Patients with newly diagnosed breast cancers ≥ 5 cm in size by palpation were treated with docetaxel/cisplatin, both at 70 mg/m2 intravenously every 21 days for 4 courses. Upon completion of chemotherapy, all patients underwent modified radical mastectomy with axillary nodal dissection. Pathologic complete response (pCR) was defined as absence of any invasive carcinoma in the breast. Standard AC (doxorubicin/cyclophosphamide) at 60 mg/m2 and 600 mg/m2, respectively, for 4 cycles was given as adjuvant therapy to maximally eradicate occult distant disease. Between March 1998 and October 2001, 57 women were entered onto this trial, 28 (49%) with inoperable T4 and inflammatory cancers. Pretreatment median tumor size was 9 cm. Thirty-six patients (63%) had estrogen receptor— positive tumors and 10 patients (18%) had tumors with HER2 overexpression. All tumors became operable after neoadjuvant chemotherapy. Pathologic complete response in the breast was achieved in 15 patients (26%) and pCR in the breast and the axilla was achieved in 11 patients (20%). All neoadjuvant chemotherapy courses were administered at full doses without treatment delays caused by toxicity. The most common side effects were hyperglycemia, anemia, and mild neuropathy. The results of this study suggest that the docetaxel/cisplatin combination can be an effective and well-tolerated induction treatment of LABC, even in very large mostly HER2-nonoverexpressing tumors.

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        • Bonadonna G
        Karnofsky memorial lecture. Conceptual and practical advances in the management of breast cancer.
        J Clin Oncol. 1989; 7: 1380-1397
        • Fisher B
        • Bryant J
        • Wolmark N
        • et al.
        Effect of preoperative chemotherapy on the outcome of women with operable breast cancer.
        J Clin Oncol. 1998; 16: 2672-2685
        • Hortobagyi GN
        • Singletary SE
        • McNeese MD
        Treatment of locally advanced and inflammatory carcinomas.
        in: Harris JRLM Morrow M Hellman S Diseases of the Breast. Lippincott-Raven, Philadelphia1996: 585-596
        • Fumoleau P
        • Chevallier B
        • Kerbrat P
        • et al.
        A multicentre phase II study of the efficacy and safety of docetaxel as first-line treatment of advanced breast cancer: report of the Clinical Screening Group of the EORTC.
        Ann Oncol. 1996; 7: 165-171
        • Sledge Jr, GW
        • Loehrer Sr, PJ
        • Roth BJ
        • et al.
        Cisplatin as first-line therapy for metastatic breast cancer.
        J Clin Oncol. 1988; 6: 1811-1814
        • Morrell LE
        • Lee YJ
        • Hurley J
        • et al.
        A phase II trial of neoadjuvant methotrexate, vinblastine, doxorubicin, and cisplatin in the treatment of patients with locally advanced breast carcinoma.
        Cancer. 1998; 82: 503-511
        • Crown J
        Nonanthracycline containing docetaxel-based combinations in metastatic breast cancer.
        Oncologist. 2001; 6: 17-21
        • Greene FL Page DL
        • Fleming ID
        AJCC Cancer Staging Manual. 6th ed. Springer-Verlag, New York2002
        • Wypij D
        Encyclopedia of Biostatistics. John Wiley & Sons, New York1998
        • Kaplan EL
        • Meier P
        Nonparametric estimation from incomplete observations.
        J Am Stat Assoc. 1958; 53: 457-481
        • Parmar MM
        • Machin D
        Survival analysis: a practical approach. John Wiley & Sons, Chichester, UK1995
        • Miller AB
        • Hoogstraten B
        • Staquet M
        • et al.
        Reporting results of cancer treatment.
        Cancer. 1981; 47: 207-214
        • Kuerer HM
        • Newman LA
        • Smith TL
        • et al.
        Clinical course of breast cancer patients with complete pathologic primary tumor and axillary lymph node response to doxorubicin-based neoadjuvant chemotherapy.
        J Clin Oncol. 1999; 17: 460-469
        • Bonadonna G
        • Veronesi U
        • Brambilla C
        • et al.
        Primary chemotherapy to avoid mastectomy in tumors with diameters of three centimeters or more.
        J Natl Cancer Inst. 1990; 82: 1539-1545
        • Mauriac L
        • Durand M
        • Avril A
        • et al.
        Effects of primary chemotherapy in conservative treatment of breast cancer patients with operable tumors larger than 3 cm. Results of a randomized trial in a single centre.
        Ann Oncol. 1991; 2: 347-354
        • Bonadonna G
        • Valagussa P
        • Brambilla C
        • et al.
        Primary chemotherapy in operable breast cancer: eight-year experience at the Milan Cancer Institute.
        J Clin Oncol. 1998; 16: 93-100
        • Smith IE
        • Walsh G
        • Jones A
        • et al.
        High complete remission rates with primary neoadjuvant infusional chemotherapy for large early breast cancer.
        J Clin Oncol. 1995; 13: 424-429
        • Collecchi P
        • Baldini E
        • Giannessi P
        • et al.
        Primary chemotherapy in locally advanced breast cancer (LABC): effects on tumour proliferative activity, bcl-2 expression and the relationship between tumour regression and biological markers.
        Eur J Cancer. 1998; 34: 1701-1704
        • Honkoop AH
        • Luykx-de Bakker SA
        • Hoekman K
        • et al.
        Prolonged neoadjuvant chemotherapy with GM-CSF in locally advanced breast cancer.
        Oncologist. 1999; 4: 106-111
        • Machiavelli MR
        • Romero AO
        • Perez JE
        • et al.
        Prognostic significance of pathological response of primary tumor and metastatic axillary lymph nodes after neoadjuvant chemotherapy for locally advanced breast carcinoma.
        Cancer J Sci Am. 1998; 4: 125-131
        • Skinner KA
        • Dunnington G
        • Silberman H
        • et al.
        Preoperative 5-fluorouracil and radiation therapy for locally advanced breast cancer.
        Am J Surg. 1997; 174: 705-707
        • Formenti SC
        • Dunnington G
        • Uzieli B
        • et al.
        Original p53 status predicts for pathological response in locally advanced breast cancer patients treated preoperatively with continuous infusion 5-fluorouracil and radiation therapy.
        Int J Radiat Oncol Biol Phys. 1997; 39: 1059-1068
        • Chollet P
        • Charrier S
        • Brain E
        • et al.
        Clinical and pathological response to primary chemotherapy in operable breast cancer.
        Eur J Cancer. 1997; 33: 862-866
        • Moliterni A
        • Tarenzi E
        • Capri G
        • et al.
        Pilot study of primary chemotherapy with doxorubicin plus paclitaxel in women with locally advanced or operable breast cancer.
        Semin Oncol. 1997; 24 (S17-14): S17-10
        • Gradishar WJ
        Docetaxel as neoadjuvant chemotherapy in patients with stage III breast cancer.
        Oncology (Huntingt). 1997; 11: 15-18
        • Perez EA
        • Hillman DW
        • Stella PJ
        • et al.
        A phase II study of paclitaxel plus carboplatin as first-line chemotherapy for women with metastatic breast carcinoma.
        Cancer. 2000; 88: 124-131
        • Loesch D
        • Robert N
        • Asmar L
        • et al.
        Phase II multicenter trial of a weekly paclitaxel and carboplatin regimen in patients with advanced breast cancer.
        J Clin Oncol. 2002; 20: 3857-3864