Safety of adjuvant dose-dense chemotherapy with paclitaxel and epirubicin for high-risk breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the safety and tolerance of adjuvant dose-dense chemotherapy with paclitaxel and epirubicin for high-risk breast cancer.</p><p><b>METHODS</b>From January 2004 to December 2006, 101 patients with high-risk breast cancer after surgical resection were enrolled into this study. The patients were divided into two groups: dose-dense and regular groups. Each patient received 6 cycles of chemotherapy with intravenous administration of paclitaxel (175 mg/m2, on D3) and epirubicin (60 mg/m2, on Dl and D2). The dose-dense group had repeated treatment every two weeks, while the regular group repeated it every three weeks. G-CSF was used in a dose of 3 microg/kg on D5-D9 during each cycle in the dose-dense group. While in the regular group, it was used only under the condition that grade II neutropenia occurred.</p><p><b>RESULTS</b>The toxicity could be evaluated in 101 patients. Major grade II-IV toxicities included: neutropenia, nausea, vomiting and alopecia. The incidence of grade III-IV neutropenia was 16.0% in the dose-dense group versus 54.9% in the regular group (P = 0.000); postponing of chemotherapy was 2.4% versus 6.0% (P = 0.027). Ninety-eight patients completed the chemotherapy as planed. After a median follow-up of 24 months, the median DFS and OS were not reached. The relapse-free rate and survival rate were 89.8% and 100% in the dose-dense group, which were 87.8% and 93.9% in the regular group. The relapse-free rate of the high-risk patients in the dose-dense group was 86.8% versus 81.3% in the regular group, and the corresponding survival rate was 100% versus 90.6%.</p><p><b>CONCLUSION</b>Adjuvant dose-dense chemotherapy with paclitaxel and epirubicin is safe, tolerable and promising for high-risk breast cancer.</p>

Paclitaxel plus carboplatin for women with advanced breast cancer / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of combination chemotherapy with paclitaxel and carboplatin for advanced breast cancer (ABC).</p><p><b>METHODS</b>From January 2001 to March 2006, 45 patients with ABC were treated with combination chemotherapy of paclitaxel and carboplatin. Patients received infusion of paclitaxel 175 mg/m2 on day 1 every 3 weeks or 75 mg/m2 on day 1, 8, 15 every 4 weeks. Carboplatin was administrated on day 2 with a dose of area under the time-concentration curve (AUC) being 5.</p><p><b>RESULTS</b>The median number of cycles was 3 (range, 2-6). The overall response rate was 62.2%. Median time to progression was 7.0 months (95% CI: 5.1-8.9). Median overall survival was 29.0 months (95% CI: 20.1-37.9). One year survival rate was 73.3%. Response rate for first line and second line treatment were 62.1% and 62.5% , respectively. No significant difference in response existed between visceral metastasis and soft tissue metastasis. The main side effects included nausea/vomiting, neurotoxicity, and hematologic toxicities. Grade III to IV adverse events included nausea/vomiting in 2 cases (4.4%), leukopenia in 17 cases (37.8%) , and alopecia in 6 cases (13.3%).</p><p><b>CONCLUSION</b>Combination of paclitaxel and carboplatin is active in treatment of ABC with an acceptable toxicity profile.</p>

Clinical characteristics and prognosis of breast cancer patients with vascular invasion / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the clinicopathological features, parameters of molecular biology, survival rate, and prognostic factors in breast cancer patients with vascular invasion.</p><p><b>METHODS</b>The data of 262 breast cancer patients with vascular invasion surgically treated between January 1995 and December 2003 in our institution were retrospectively analyzed. Clinicopathological characteristics, parameters of molecular biology, disease free survival rate and overall survival rate were surveyed.</p><p><b>RESULTS</b>Of all breast cancer patients registered in our institution during the same period, these 262 breast cancer patients with vascular invasion accounted for 5.3% with a median age of 43 years. The major pathological type was invasive ductal carcinoma (93.3%). The stages included stage I in 5% , stage II 31. 3% , stage III 58.8% , stage IV 1.1% , and unknown 3.8%. Immunohistochemical staining showed that ER positive in 67.7%, PR(+) 68.0%, p53(+) 54.2%, PCNA(+) 93.3%, c-erbB2( +++) 20.8% and c-erbB2(++) 16.9%. The 5-year and 10-year cumulative disease free survival and overall survival were 57.6% , 50.7% and 62.8%, 52.9% , respectively. The factors which were found to compromise disease free survival were the tumor size, lymph node status, stage, and radiotherapy in the univariate analysis, and for overall survival, were the tumor size, lymph node status, stage, location of vascular invasion and radiotherapy. The tumor size and radiotherapy were found to be independent prognostic factors for disease free survival and overall survival in the multivariate analysis.</p><p><b>CONCLUSION</b>Breast cancers with vascular invasion have poor biological behavior though having been treated by surgery, radiotherapy and chemotherapy. The independent prognostic factors of such patients are tumor size and radiotherapy. Anti-angiogenesis and antilymphangiogenesis may gradually become promising target treatment for such patient.</p>

Docetaxel combined with cisplatin in the treatment of anthracycline-resistant advanced breast cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of combination chemotherapy of Docetaxel (Taxotere, TXT) combined with cisplatin (DDP) for anthracycline (ANT)-resistant advanced breast cancer (ABC).</p><p><b>METHODS</b>From April 2000 to March 2005, 31 patients with ANT-resistant advanced breast cancer were treated with combination chemotherapy of TXT and DDP. TXT 75 mg/m2 and DDP 75 mg/m2 were used on day 1 every three weeks. The median number of cycles was 4 (range: 2 - 8 cycles).</p><p><b>RESULTS</b>The overall combination chemotherapy response rate was 54.9% with a median time to progression of 5 months. One-year survival rate was 66.7%. The main side effects were gastrointestinal and hematologic toxicities, including grade 3 to 4 nausea and vomiting in 3 patients (9.7%), leukopenia in 6 (19.3%), and neutropenia in 3 (9.7%).</p><p><b>CONCLUSION</b>Taxotere and displatin combination is active in the treatment for anthracycine-resistant advanced breast cancer patient with an acceptable toxicity, and may be a therapeutic alternative after anthracycline regimen has failed.</p>