A randomized phase II trial comparing docetaxel plus cyclophosphamide with epirubicin plus cyclophosphamide followed by docetaxel as neoadjuvant chemotherapy for hormone receptor-negative breast cancer: Kanagawa Breast Oncology Croup (KBOG) 1101 study.

Authors

null

Takashi Ishikawa

Department of Breast and Thyroid Surgery, Yokohoma City University Medical Center, Yokohama, Japan

Takashi Ishikawa , Daisuke Shimizu , Mikiko Tanabe , Mari S.Oba , Takeshi Sasaki , Satoshi Morita , Kumiko Kida , Shuichi Nawata , Masatoshi Mogaki , Takako Doi , Koichiro Tsugawa , Haruki Ogata , Yoshimasa Kosaka , Norihiko Sengoku , Yasuhiro Suzuki , Akihiko Suto , Takashi Chishima , Yasushi Ichikawa , Itaru Endo , Yutaka Tokuda

Organizations

Department of Breast and Thyroid Surgery, Yokohoma City University Medical Center, Yokohama, Japan, Breast and Thyroid Surgery, Pathology, and Biostatistics, Yokohama City University Medical Center, Knagawa, Japan, Breast and Thyroid Surgery, Pathology, and Biostatistics, Yokohama City University Medical Center, Kanagawa, Japan, Yokohama City University Medical Center, Kanagawa, Japan, Surgery, Yokosuka Kyosai Hospital, Kanagawa, Japan, Breast Surgery, Shonan-kinen Hospital, Kanagawa, Japan, Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kanagawa, Japan, Surgery, Kitasato University, Kanagawa, Japan, Tokai University School of Medicine, Isehara Kanagawa, Japan, Clinical Oncology and Gastrointestinal Surgery, Yokohama City University, Kanagawa, Japan, Yokohama City University Hospital, Yokohama, Japan, Tokai University School of Medicine, Kanagawa, Japan

Research Funding

Other Foundation

Background: Taxane-based regimens have been widely used to treat breast cancer. Accordingly, it has become important to identify subgroups in which anthracyclines are indispensable. Thus, we initiated a randomized phase II neoadjuvant chemotherapy (NAC) study to compare taxane with and without anthracycline in hormone-negative subtypes. Methods: Eligibility criteria were hormone-negative, an age younger than 80 years and ECOG PS0-1. According to HER2 status, patients were randomly assigned to TC (75/600 mg/m2) q3wks ×6 or FEC (500/100/500 mg/m2) q3wks ×3 followed by D (100 mg/m2) q3wks ×3. The primary endpoint was the rate of pathological complete response (pCR; Grade 3 and Quasi-pCR; Grade 3+2b). Secondary endpoints were safety, breast-conserving surgery ratio, disease-free survival, overall survival, and predictive factors (HER2, Ki-67, P-53, CK5/6, EGFR, and TOP2A by IHC and TOP2A by FISH) for each regimen. Results: 97 out of 103 patients were successfully analyzed (47 for TC6 and 50 for FEC-D). Severe adverse events (Grade ≥2) were frequently observed in FEC-D-treated patients with statistical significance (poor appetite, nausea/vomiting: p<0.001; febrile neutropenia: p=0.016). The pCR rate tended to be higher in FEC-D-treated patients compared with that of TC6-treated patients (pCR: 36.0 vs. 25.5%, n.s.; Quasi-pCR: 46.0 vs. 40.4%, n.s.). There was no significant difference of pCR rates in the HER2 and triple negative (TN) subtypes between each regimen. Among predictors, only positive markers CK5/6 and EGFR predicted the superiority of the FEC-D treatment (p=0.05). Conclusions: TC6 was safe and relatively active even in HER2 subtype patients. Therefore, the concurrent use of trastuzumab with TC could be a reasonable option for NAC in HER2 subtype patients. However, anthracyclines are required to treat basal-type TN cancer. Clinical trial information: UMIN000002215.

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2013 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Breast Cancer - Triple-Negative/Cytotoxics/Local Therapy

Track

Breast Cancer

Sub Track

Triple-Negative Breast Cancer

Clinical Trial Registration Number

UMIN000002215

Citation

J Clin Oncol 31, 2013 (suppl; abstr 1047)

DOI

10.1200/jco.2013.31.15_suppl.1047

Abstract #

1047

Poster Bd #

19F

Abstract Disclosures