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Abstract
Trastuzumab/chemotherapy combinations have already shown superior results in metastatic
breast cancer patients. The purpose of this study is to determine the clinical efficacy
of neoadjuvant trastuzumab and docetaxel in women with locally advanced breast cancer,
with or without metastatic disease. Treatment-naive women with HER2-overexpressing
locally advanced breast cancer, with or without metastatic disease, were included.
Patients received trastuzumab 4 mg/kg loading dose intravenously then 2 mg/kg weekly.
On day 22, docetaxel 100 mg/m2 every 3 weeks for 4 cycles was added to weekly trastuzumab. Patients then underwent
surgery and subsequent 4 cycles of AC (doxorubicin/cyclophosphamide; 60/600 mg/m2) without trastuzumab. Weekly trastuzumab was resumed 1 month after completion of
AC and continued for a year. Preliminary results from the first 22 patients with median
follow-up of 15.5 months (range, 2-38 months) are reported. Of these, 9 patients (40.9%)
had inflammatory breast cancer, and 6 patients (27.3%) had stage IV breast cancer.
Seventeen of 22 patients (77.3%) had objective clinical response, with a clinical
complete response in 9 patients (40.9%). Two patients (9.1%) had decline in cardiac
function and 7 patients (31.8%) experienced neutropenia, with 2 deaths (9.1%) from
neutropenic sepsis. Eight patients (36.4%) have relapsed, 3 with local skin recurrence
(13.6%) and 5 with distant recurrence, of whom 1 had liver metastasis (4.5%) and 4
had brain metastasis (18.2%). Combined neoadjuvant trastuzumab and docetaxel induced
high clinical response rates for HER2- overexpressing breast cancer, in particular
for inflammatory breast cancer. A high rate of brain metastasis was noted, particularly
in patients with baseline metastatic disease.
Key words
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References
- Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene.Science. 1987; 235: 177-182
- Cell signaling by receptor tyrosine kinases.Cell. 2000; 103: 211-225
- Untangling the ErbB signalling network.Nat Rev Mol Cell Biol. 2001; 2: 127-137
- Structure of the extracellular region of HER2 alone and in complex with the Herceptin Fab.Nature. 2003; 421: 756-760
- Remission of human breast cancer xenografts on therapy with humanized monoclonal antibody to HER-2 receptor and DNA-reactive drugs.Oncogene. 1998; 17: 2235-2249
- Multinational study of the efficacy and safety of humanized anti-HER2 monoclonal antibody in women who have HER2-overexpressing metastatic breast cancer that has progressed after chemotherapy for metastatic disease.J Clin Oncol. 1999; 17: 2639-2648
- Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2.N Engl J Med. 2001; 344: 783-792
- Inhibitory effects of combinations of HER-2/neu antibody and chemotherapeutic agents used for treatment of human breast cancers.Oncogene. 1999; 18: 2241-2251
- Her-2/neu overexpression and in vitro chemosensitivity to CMF and FEC in primary breast cancer.Breast Cancer Res Treat. 2001; 69: 53-63
- Cardiac dysfunction in the trastuzumab clinical trials experience.J Clin Oncol. 2002; 20: 1215-1221
- Docetaxel in the treatment of breast cancer: an update on recent studies.Semin Oncol. 2002; 29: 28-34
- Decreased response to paclitaxel versus docetaxel in HER-2/neu transfected human breast cancer cells.Am J Clin Oncol. 2003; 26: 50-54
- A phase II trial of weekly doc etaxel and herceptin as first-or second-line treatment in HER2 overexpressing metastatic breast cancer.Proc Am Soc Clin Oncol. 2001; 20 (Abstract #1949).: 50b
- Safety and activity of docetaxel and trastuzumab in HER2 overexpressing metastatic breast cancer: a pilot phase II study.Am J Clin Oncol. 2003; 26: 95-97
- Docetaxel (Taxotere) plus trastuzumab (Herceptin) in breast cancer.Semin Oncol. 2001; 28: 38-44
- Preoperative therapy with trastuzumab and paclitaxel followed by sequential adjuvant doxorubicin/cyclophosphamide for HER2 overexpressing stage II or III breast cancer: A pilot study.J Clin Oncol. 2003; 21: 46-53
- Phase II study of weekly docetaxel and trastuzumab for patient with HER-2 overexpressing metastatic breast cancer.J Clin Oncol. 2002; 20: 1800-1808
- Inflammatory breast cancer: the experience of the surveillance, epidemiology, and end results (SEER) program.J Natl Cancer Inst. 1985; 74: 291-297
- The physiology of the breast as it concerns the clinician.Am J Obstet Gynecol. 1971; 109: 206-209
- Inflammatory breast cancer: a review.J Clin Oncol. 1992; 10: 1014-1024
- The development and clinical use of trastuzumab (Herceptin).Endocr Relat Cancer. 2002; 9: 75-85
Article Info
Publication History
Submitted: ??; Revised: ??; Accepted: ??
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© 2003 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
