15. Response to dose-dense 4AC-4T regimen in neoadjuvant treatment of stage III breast cancer
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Abstract
This descriptive study with longitudinal follow-up was conducted t evaluate the response to dose-dense 4AC-4T regimen in neoadjuvant treatment of stage III breast cancer at Viet Nam National Cancer Hospital and Ha Noi Oncology Hospital from January 2015 to December 2022. 211 patients were enrolled in the study with the mean age of 45.1 years old (range 26 – 65 years old). Stages IIIA, IIIB, and IIIC represented 55.5%, 28.9%, and 15.6%, respectively. Luminal B HER2 negative accounted for the highest rate: 40.3%; triple negative (20.4%); Luminal A (16.6%); HER2 positive (10.4%); Luminal B HER2 positive (7.6%). The overall response rate (ORR) reached 92.9%, of which the clinical complete response rate reached 18.0%. The pathological complete response (pCR) rate reached 24.2%. In conclusion, stage III breast cancer is highly responsive to the dose dense 4AC-4T regiment.
Article Details
Keywords
Breast cancer, neoadjuvant chemotherapy, dose-dense regimen, pathological complete response
References
2. Kong X, Moran MS, Zhang N, Haffty B, Yang Q. Meta-analysis confirms achieving pathological complete response after neoadjuvant chemotherapy predicts favourable prognosis for breast cancer patients. European journal of cancer. Sep 2011; 47(14): 2084-90. doi:10.1016/j.ejca.2011.06.014.
3. Citron ML, Berry DA, Cirrincione C, et al. Randomized trial of dose-dense versus conventionally scheduled and sequential versus concurrent combination chemotherapy as postoperative adjuvant treatment of node-positive primary breast cancer: first report of Intergroup Trial C9741/Cancer and Leukemia Group B Trial 9741. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. Apr 15 2003; 21(8): 1431-9. doi:10.1200/JCO.2003.09.081.
4. Đỗ Huyền Nga, Nguyễn Tiến Quang. Đánh giá hiệu quả hóa trị phác đồ ACT liều dày trong điều trị bổ trợ trước ung thư vú giai đoạn lan rộng vùng không có khả năng phẫu thuật triệt căn tại Bệnh viện K từ 2015-2018. Tạp chí Y học Việt Nam. 2020; 488(1): 81-86.
5. Nguyễn Thị Minh Phương, Phạm Đình Phúc, Nguyễn Ngọc Minh Tiến. Hiệu quả của phác đồ 4AC-4T liều dày trong điều trị tân bổ trợ ở bệnh nhân ung thư vú giai đoạn II, III. Tạp chí Y dược lâm sàng 108. 2022;17(Số đặc biệt 11/2022: Hội nghị trao đổi, chia sẻ kinh nghiệm chuyên môn Quân y Việt-Lào lần thứ VII năm 2022): 162-168.
6. Goldhirsch A, Winer EP, Coates AS, et al. Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013. Annals of oncology : official journal of the European Society for Medical Oncology. Sep 2013; 24(9): 2206-23. doi:10.1093/annonc/mdt303.
7. Park JO, Lee SI, Song SY, et al. Measuring response in solid tumors: comparison of RECIST and WHO response criteria. Japanese journal of clinical oncology. Oct 2003; 33(10): 533-7. doi:10.1093/jjco/hyg093.
8. Penault-Llorca F, Abrial C, Raoelfils I, et al. Comparison of the prognostic significance of Chevallier and Sataloff’s pathologic classifications after neoadjuvant chemotherapy of operable breast cancer. Human pathology. Aug 2008; 39(8): 1221-8. doi:10.1016/j.humpath.2007.11.019.
9. Catane R, Kaufman B, Zach L, et al. Dose-dense neoadjuvant chemotherapy in breast cancer. Journal of Clinical Oncology. 2005; 23(16_suppl): 807-807. doi:10.1200/jco.2005.23.16_suppl.807.
10. Antolín S, Mel R, Ramos M, et al. A dose-dense schedule of docetaxel followed by doxorubicin and cyclophosphamide as neoadjuvant treatment for breast cancer: results from a phase II study. Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico. Sep 2011; 13(9): 686-91. doi:10.1007/s12094-011-0715-9.
11. Lê Thanh Đức. Nghiên cứu hiệu quả hóa trị bổ trợ trước phẫu thuật phác đồ AP trong ung thư vú giai đoạn III. Luận án Tiến sĩ y học. Trường Đại học Y Hà Nội; 2014.
12. Untch M, Fasching PA, Konecny GE, et al. PREPARE trial: a randomized phase III trial comparing preoperative, dose-dense, dose-intensified chemotherapy with epirubicin, paclitaxel and CMF versus a standard-dosed epirubicin/cyclophosphamide followed by paclitaxel ± darbepoetin alfa in primary breast cancer--results at the time of surgery. Annals of oncology : official journal of the European Society for Medical Oncology. Sep 2011; 22(9): 1988-1998. doi:10.1093/annonc/mdq709.
13. Ding Y, Ding K, Yang H, He X, Mo W, Ding X. Does dose-dense neoadjuvant chemotherapy have clinically significant prognostic value in breast cancer?: A meta-analysis of 3,724 patients. PloS one. 2020; 15(5): e0234058. doi:10.1371/journal.pone.0234058.
14. Minckwitz GV, Untch M, Nueesch E, et al. Impact of treatment characteristics on response of different breast cancer subtypes: Pooled multilayer analysis of the German neoadjuvant chemotherapy trials. Journal of Clinical Oncology. 2010; 28(15_suppl): 501-501. doi:10.1200/jco.2010.28.15_suppl.501.