Oncology Medical News about dose-dense epirubicin/cyclophosamide;docetaxel/capecitabine;HER-2negative breast cancer;locally advanced;node-positive breast cancer

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Sequential administration of dose-dense epirubicin/cyclophosphamide followed by docetaxel/capecitabine for patients with HER2-negative and locally advanced or node-positive breast cancer
Cancer Chemotherapy and Pharmacology, 06/19/09

Nieto Y et al. - In a study to determine whether sequential treatment with dose-dense epirubicin/cyclophosphamide (EC) and docetaxel/capecitabine would be active and tolerable in the adjuvant/neoadjuvant setting, it was reported that this regimen, using a lower capecitabine dose than that approved for metastatic breast cancer (MBC), has an acceptable toxicity profile and encouraging activity when used as neoadjuvant or adjuvant treatment of breast cancer.

Methods

Pts with HER2-negative and node-positive or locally advanced tumors were eligible to receive 4 cycles of EC (100/600 mg/m2) every 2 wks with G-CSF on days 3–10, followed by 4 cycles of docetaxel/capecitabine (75/1000 mg/m2 bid, days 1–14) every 3 wks.

Results

55 pts were enrolled with median age of 49, and 80% had hormone receptor-positive disease.
Median tumor size was 2.5 cm, with a median of 2 axillary nodes involved.
75% of the first 20 pts had grade 2/3 hand-foot syndrome (HFS).
Dose reduction of capecitabine to 800 mg/m2 reduced the grade 2/3 HFS incidence to 31% in remaining pts.
No grade 4/5 toxicities were observed.
All 20 pts treated preoperatively responded, with 5 (25%) pathologic complete responses and 3 additional pT0N1 tumors.
At a median follow-up of 48 mos, event-free and overall survival rates are 91 and 98%, respectively.

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