Phase 2 trial of primary systemic therapy with doxorubicin and docetaxel followed by surgery, radiotherapy, and adjuvant chemotherapy with cyclophosphamide, methotrexate, and 5-fluorouracil based on clinical and pathologic response in patients with stage IIB to III breast cancer: Long-term results from the University of Texas M. D. Anderson Cancer Center Study ID97-099

Ricardo H. Alvarez, Daniel J. Booser, Massimo Cristofanilli, Aysegul A. Sahin, Eric A. Strom, Laura Guerra, Shu Wan Kau, Ana M. Gonzalez-Angulo, Gabriel N. Hortobagyi, Vicente Valero*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

BACKGROUND: This study was performed to evaluate the outcomes of patients with locally advanced breast cancer (LABC)whowere treatedwith amultidisciplinary approach including primary systemic chemotherapy and noncross-resistant adjuvant chemotherapy. METHODS: Patients with LABC received 4 or 6 cycles of doxorubicin and docetaxel (DT) as primary systemic chemotherapy (PST) every 21 days. Patients with adequate response underwent surgery followed by adjuvant chemotherapy according to pathologic response: complete (pCR), 2 more cycles of DT; partial (pPR), 2 more cycles of DT followed by 6 cycles of cyclophosphamide,methotrexate, and 5-fluorouracil (5-FU) (CMF); andminor (pMR), 6 cycles of CMF. Patients then received radiation and tamoxifen (hormone receptor-positive patients only). RESULTS: Eighty-eight patients were evaluable. Seventy-four patients had an adequate response to DT and were considered operable, and 72 underwent surgery.Ten patients (13.9%) achieved a pCR, 22 (30.5%) achieved a pPR, and 40 achieved a pMR (55.5%). Fourteen patientswere considered nonoperable after DTand underwent salvage CMF therapy. Five of these patients underwent surgery and 1 had achieved a pCR. The estimated 5-year recurrence-free survival (RFS) rates for patients with pCR, pPR, and pMR were 80%, 77%, and 59%, respectively, and the estimated 5-year overall survival (OS) rates were 90%, 91%, and 74%, respectively. The 5-year OS rates were 82% for initially operable and 21% for initially inoperable patients (P ≤ .001) CONCLUSIONS: Multidisciplinary therapy that includes PSTwith DTand adjuvant therapy with CMF administered according to the clinical and pathologic response is associated with high long-term RFS and OS rates in patients with LABC. Clinical or pathologic PR or CR to DT predicts improved RFS and OS.

Original languageEnglish (US)
Pages (from-to)1210-1217
Number of pages8
JournalCancer
Volume116
Issue number5
DOIs
StatePublished - Mar 1 2010

Keywords

  • Anthracylines
  • Breast cancer
  • CMF regimen
  • Inflammatory breast cancer
  • Locally advanced breast cancer
  • Primary systemic therapy
  • Taxanes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Fingerprint Dive into the research topics of 'Phase 2 trial of primary systemic therapy with doxorubicin and docetaxel followed by surgery, radiotherapy, and adjuvant chemotherapy with cyclophosphamide, methotrexate, and 5-fluorouracil based on clinical and pathologic response in patients with stage IIB to III breast cancer: Long-term results from the University of Texas M. D. Anderson Cancer Center Study ID97-099'. Together they form a unique fingerprint.

Cite this