Neoadjuvant chemotherapy for locally advanced breast cancer; impact on reponse rate

ABSTRACT

This is a prospective phase II study done in locally advanced breast cancer patients with the aim of assessment of clinical and pathological response rate after neoadjuvant chemotherapy and time to disease progression. Thirty patients with locally and advanced breast cancer were included in the study. All eligible patients were given neoadjuvant chemotherapy as two cycles of Doxorubicin and Cyclophosphamide [AC], then two cycles of Docetaxel, and Cisplatinum [DP]. Post-treatment clinical and radiological assessment was done, whereby those patients who achieved complete remission [CR] or partial remission [PR] were referred for mastectomy, while those who progressed on neoadjuvant chemotherapy were excluded from the study. Pathological evaluation of mastectomy specimens was done for all patients to assess the pathological response rate. The results showed that 30 patients of locally advanced [stage IIIA and IIIB] breast cancer were included in this study. Twenty-seven patients [90%] showed complete clinical and radiological remission [CR]; while, three cases [10%] showed partial clinical and radiological remission [PR]. Regarding pathological response three cases [10%] showed complete pathologic response, while the rest of cases [90%] showed residual disease. There was no correlation between clinical and pathological response rates. Treatment related toxicities were nausea GI-II in 14 cases [47%], vomiting GI-II in 10 cases [33%], alopecia GII-III in all patients [100%], neutropenia GII in 11 cases [37%]. Docetaxel related toxicity was seen as allergic reaction in two cases [7%], mild peripheral neuropathy was seen in six cases [20%], No life threatening complications and no toxic deaths were observed. After a median follow up of 12 months, two cases out of 14 [14%] showed relapse [14%] and at the end of the study three cases out of total 30 [10%] relapsed