scholarly journals Sequential dose-dense single agent chemotherapy for locally advanced breast cancer

2003 ◽  
Vol 11 (3) ◽  
pp. 149-149
Author(s):  
Svetislav Vrbic ◽  
Ivica Pejcic ◽  
Sladjana Filipovic ◽  
Stojan Radic
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Single Agent ◽  
Locally Advanced ◽  
Conservative Surgery ◽  
Advanced Breast ◽  
Dose Dense ◽  
Novel Concept ◽  
Single Agent Chemotherapy

Chemotherapy of breast cancer is still the area of intensive research. Based on mathematical model of tumor cell growth kinetics, articulated by Larry Norton, novel concept of chemotherapy in breast cancer was launched and it implies dose-densification of chemotherapy trough the use of sequential non cross-resistant single agents or regimens. The introduction of primary systemic chemotherapy (PST) improved the outcome of patients with locally advanced breast cancer (LABC). Simultaneous PST is the standard approach to patients with LABC nowadays. On the other hand, many studies using two most active cytotoxic drugs in primary breast cancer, anthracyclines and taxanes showed that sequential dose-dense single agent PST could be superior in terms of enhancing the rates of patients suitable for conservative surgery. In the light of this data, based on the results of the new clinical trials we will discuss merits and demerits of using sequential dose-dense single agent chemotherapy in LABC.

scholarly journals Ixabepilone as Monotherapy or in Combination with Capecitabine for the Treatment of Advanced Breast Cancer

2011 ◽  
Vol 5 ◽  
pp. BCBCR.S5331 ◽  
Author(s):  
Katherine H. Rak Tkaczuk
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Response Rate ◽  
Locally Advanced Breast Cancer ◽  
Single Agent ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Prior Exposure ◽  
Phase Iii ◽  
Overall Response

Breast Cancer is the most prevalent cancer in the world with 4.4 million survivors up to 5 years following the diagnosis. 1 In the US alone approximately forty thousand women die annually of metastatic breast cancer (MBC). Despite many effective systemic treatment options approximately 50% of women with MBC succumb to the disease within 24 months of the diagnosis. 2 Ixabepilone is a novel, first in class member of the epothilone class of antineoplastic agents. Ixabepilone is indicated as monotherapy for the treatment of metastatic or locally advanced breast cancer in patients whose tumors are resistant or refractory to anthracyclines, taxanes, and Capecitabine. Ixabepilone is also indicated in combination with Capecitabine for the treatment of patients with metastatic or locally advanced breast cancer resistant to treatment with an anthracycline and a taxane, or whose cancer is taxane resistant and for whom further anthracycline therapy is contraindicated. Ixabepilone was extensively studied as a single agent in patients with MBC and was found to be effective and well tolerated with a predictable and manageable safety profile. Not surprisingly prior exposure to anthracyclines and taxanes affects significantly the potential for response to therapy with single agent Ixabepilone in metastatic setting. MBC patients with taxane resistant MBC have objective response rate (RR) of 12%, patients with prior low exposure to taxanes and/or resistance RR = 22%, Ixabepilone treatment after adjuvant anthracycline therapy exposure renders RR = 42% and in Taxane naïve patients RR = 57%. In two large phase III studies of Ixabepilone + Capecitabine versus Capecitabine alone, progression free survival (PFS) and overall response rates (RR) were higher in the combination treatment arms, but no survival advantage was seen overall. Treatment with Ixabepilone + Capecitabine in a phase II study resulted in an overall response rate (ORR) of 23% in ER/PR/HER2 negative, triple-negative breast cancer patients (TNBC) while ORR of 31% was seen in a preplanned pooled analysis of TNBC in the phase III trials of Ixabepilone + Capecitabine. Significantly prolonged median PFS was seen for TNBC treated with the combination of Ixabepilone + Capecitabine compared to Capecitabine alone 4.2 vs. 1.7 months respectively. Ixabepilone as single agent appears to show excellent antitumor activity in patients with TNBC MBC. Addition of Ixabepilone to Capecitabine results in approximately doubling in median PFS for TNBC versus Capecitabine alone. Single agent Ixabepilone is generally well tolerated, and its toxicity profile does not overlap with that of Capecitabine and therefore depending on prior exposure to chemotherapy both single agent Ixabepilone or in combination with Capecitabine can be used safely and effectively for treatment of advanced breast cancer.

scholarly journals The peculiarities of surgical service of locally advanced breast cancer after neoadjuvant systemic treatment

2015 ◽  
Vol 22 (3) ◽  
pp. 42-47
Author(s):  
O. L. Petrenko
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Advanced Breast Cancer ◽  
Systemic Treatment ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Radical Mastectomy ◽  
Conservative Surgery ◽  
Advanced Breast ◽  
Treatment Stage

Patients with locally advanced (T2-4N0-3M0) breast cancer, receiving neoadjuvant systemic treatment with the following application of surgical treatment stage (radical mastectomy or conservative surgery) were selected from the data base. The data of the first cancer register in the Russian Federation, disposing the data base for more than 5000 patients with breast cancer were analyzed in this work. Consistent with the primary goal of the work the information about 286 patients with locally advanced breast cancer (clinical stages IIB-IIB), receiving neoadjuvant systemic treatment with the following application of surgical treatment stage (radical mastectomy or conservative surgery), was obtained from the date base. The follow up period is from 2 to 10 years. The estimation of application efficiency of neoadjuvant chemotherapy, hormonal treatment and target therapy was done. The basic clinical, pathomorphological and biological factors (HER2, ER, PR, degree of malignancy), decisive for planning of relevant neoadjuvant treatment, enabling to customize medical disposal for a patient and contributing to the increase of comprehensive treatment, rising of general and relapse free survival of patients with locally advanced breast cancer, who underwent breast-conserving surgeries.

Primary chemotherapy in breast cancer shows excellent clinical and pathological response with docetaxel and epirubicin

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10779-10779
Author(s):  
H. R. Marana ◽  
J. M. Andrade ◽  
D. G. Tiezzi ◽  
F. E. Zola ◽  
H. H. Carrara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Tumour Response ◽  
Conservative Surgery ◽  
Pathological Response ◽  
Advanced Breast ◽  
New Drugs ◽  
Primary Chemotherapy

10779 Background: Primary chemotherapy is becoming the standard of care for locally advanced breast cancer. Recently tested regimens using new drugs have been showing better results than usual anthracycline based treatments. Methods: From April 1998 through April 2004, 104 patients (18 stage IIA; 36 stage IIB; 13 stage IIIA; 33 stage IIIB; 4 stage IV) were included in the trial and received three cycles of docetaxel 75 mg/m2 and epirubicin 50 mg/m2 (q3w). Patients with stable or progressive disease were excluded from the trial, receiving alternative treatment. Those with partial response after three cycles but still not suitable for conservative surgery received up to 3 additional cycles. Following completion of the chemotherapy regimen, tumour response was assessed and appropriate surgery performed. Pathological response was evaluated in excised specimens. Results: According to the UICC criteria for clinical evaluation, 79 pts (76%) had objective regression (14 CR and 65 PR); 21 resulted in stabilised disease and 4 showed progression (24%). There was no toxicity in 62 patients, grade I/II in 4 and grade III/IV in seven patient. Ninity-nine patients became eligible for surgery (95%); 60 underwent conservative surgical treatment (60.6%) and in 39 patients a modified radical surgery was done (39.4%). No axyllary involvement were detected in 22 patients, other 23 had 1–3 positive nodes and 54 had 3 or more positives node in axillary dissection. 338 chemotherapy cycles were given, with an average of previously expected 3.25 cycles per patient. Conclusions: Our study demonstrates a high response rate with primary docetaxel and epirubicin chemotherapy in locally advanced breast cancer and high axillary envolvement group, enabling conservative surgery to take place and carrying no significant toxicity. Survival rate was directly linked to pathological response and complete response was associated to highest rate of survival in the group. No significant financial relationships to disclose.

Neo-adjuvant therapy with dose-dense docetaxel plus short-term filgrastim rescue for locally advanced breast cancer

2002 ◽  
Vol 13 (8) ◽  
pp. 791-795 ◽  
Author(s):  
Paolo Alberto Paciucci ◽  
George Raptis ◽  
Ira Bleiweiss ◽  
Christina Weltz ◽  
Deborah Lehrer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Short Term ◽  
Dose Dense
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