Aim To compare the effect of neoadjuvant chemotherapy based on taxane and/or anthracycline to the extent of an objective response in female patients with unresectable breast cancer with evaluation of the toxic profile of applied chemotherapy. Methods One hundred patients with histologically verified breast cancer, treated with neoadjuvant chemotherapy were divided into two groups: a study group A (50 patients), who had received 4 to 6 cycles of taxane-based chemotherapy, and control group B (50 patients), who had received 4 to 6 cycles of anthracyclines-based chemotherapy. Pathohistological response was evaluated after tumour excision and axillary resection at the end of chemotherapy and it was defined as pathologic complete (pCR), partial (pPR), or no response (pNR). Toxic effects were evaluated and quantified by the Common Terminology Criteria for Adverse Events v4.0. Results After neoadjuvant chemotherapy, 8% of patients in the group A achieved pCR, 54% achieved pPR, while 38% of patients had no tumour response to applied chemotherapy. In the group B pCR was achieved in 6%, pPR in 42% of patients, while 51% of patients were pNR to the administered chemotherapy. Significant reduction of tumour mass was achieved in the group of patients treated with taxanes: 20.00 (7.75-30.25) vs. 13.50 (6.00-25.00) mm (p=0.024). Toxicity of chemotherapy in group A and group B was within the limits of grade 2. Conclusion The addition of taxane to anthracycline-based neoadjuvant chemotherapy in patients with breast cancer resulted in a significant reduction in tumour mass compared to the group of patients treated with anthracyclines, but without increasing the overall side effects.
Common Terminology Criteria for Adverse Events, Version 4.0, DCTD, NCI, NIH, DHHS 2010. Cancer Therapy Evaluation Program 10AD.
2
Martín M, Seguí M, Antón A, Ruiz A, Ramos M, Adrover E, et al. GEICAM 9805 Investigators. Adjuvant docetaxel for high-risk. N Engl J Med 2010:2200–10.
3
Mackey J, Martin M, Pienkowski T, Rolski J, Guastalla J, Sami A, et al. for the TRIO/ BCIRG 001 investigators. Adjuvant docetaxel, doxorubicin, and cyclophosphamide in node-positive breast cancer: 10-year follow-up of the phase 3 randomised BCIRG 001 trial. Lancet Oncol 2013:72–80.
4
Chanan-Khan A, Srinivasan S, Czuczman M. Prevention and management of cardiotoxicity from antineoplastic therapy. J Support Oncol 2004:251–66.
5
Doroshow J, Davies K. Redox cycling og anthracyclines by cardiac mitochondria II. Formation of superoxide anion, hydrogen peroxide, and hydroxyl radical. J Biol Chem 1986:3068–74.
6
Cuppone F, Bria E, Carlini P, Milella M, Felici A, Sperduti I, et al. Taxanes as primary chemotherapy for early breast cancer. Cancer 2008:238–46.
7
Rastogi P, Anderson S, Bear H, Geyer C, Kahlenberg M, Robidoux A, et al. Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27. J Clin Oncol 2008:778–85.
8
Cortazar P, Zhang L, Untch M, Mehta K, Costantino J, Wolmark N, et al. Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet 2014:164–72.
9
Ogawa Y, Moriya T, Kato Y, Oguma M, Ikeda K, Takashima T, et al. Immunohistochemical assessment for estrogen receptor and progesterone receptor status in breast cancer: analysis for a cut-off point as the predictor for endocrine therapy. Breast Cancer 2004:267–75.
10
Minckwitz V, Untch G, Blohmer M, Costa J, Eidtmann S, Fasching H, et al. Definition and impact of patologic complete response on prognosis after neoadjuvant chemotherapy in various intrinsic breast cancer subtype. J Clin Oncol 2012:1796–804.
11
Houssami N, Macaskill P, Minckwitz V, Marinovich G, Mamounas M, E. Meta-analysis ofthe association of breast cancer subtype and pathological complete response to neoadjuvant chemotherapy. Eur J Cancer 2012:3342–54.
12
Aigner J, Schneeweiss A, Sohn C, Marme F. The role of neoadjuvant chemotherapy in the management of primary breast cancer. Minerva Ginecol 2011:261–74.
13
Raut N, Chordiya N. NEO adjuvant chemotherapy in breast cancer: What have we learned so far? Indi. J Med Pediatr Oncol 2010:8–17.
14
Howlader N, Noone A, Krapcho M, Miller D, Bishop K, Kosary C, et al. SEER Cancer Statistics Review n.d.:1975–2014.
15
Cortazar P, Zhang L, Untch M, Mehta K, Costantino J, Wolmark N, et al. Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet 2014:164–72.
16
Eisenhauer E, Therasseb P, Bogaertsc J, Schwartzd L, Sargente D, Fordf R, et al. New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1). Eur J Cancer 2009:228–47.
17
Heys S, Hutcheon A, Sarkar T, Ogston K, Miller I, Payne S, et al. Aberdeen Breast Group. Neoadjuvant docetaxel in breast cancer: 3-year survival results from the Aberdeen trial. Clin Breast Cancer 2002;(Suppl 2):69–74.
18
Pinero-Madrona A-RJ, Past A. present and future of primary systemic treatment in breast cancer. World J Obstet Gynecol 2013:21–33.
19
Doroshow J, Davies K. Redox cycling og anthracyclines by cardiac mitochondria II. Formation of superoxide anion, hydrogen peroxide, and hydroxyl radical. J Biol Chem 1986:3068.
20
Arcamone F, Cassinelli G, Fantini G, Grein A, Orezzi P, Pol C, et al. 14-hydroxydaunomycin, a new antitumor antibiotic from S. peucetius var. caesius. Biotechnolo Bioeng 1969:1101–10.
21
Nahleh Z, Sivasubramaniam D, Dhaliwal S, Sundarajan V, Komrokji R. Residual cancer burden in locally advanced breast cancer: a superior tool. Curr Oncol 2008:271–8.
22
Sparano J. Taxanes for breast cancer: an evidencebased review of randomized phase II and phase III trials. Clin Breast Cancer 2000:32–40.
23
Department of Health and Human Services. Report 2017.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.