High rate of axillary node clearence with neoadjuvant Herceptin, Taxotere, and Cisplatin in locally advanced advanced and inflammatory breast cancer

J. E. Hurley, P. Doliny, P. Velez, U. Guatam, I. Reis, Orlando E. Silva, C. Gomez-Fernandez, Y. Lee, S. X. Franco

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Neoadjuvant chemotherapy is a commonly used strategy in pts with locally advanced breast cancer(LABC)but the best combination has not been established. Herceptin added to chemotherapy significantly prolongs survival in the metastatic setting. Taxotere and Cisplatin are synergistic with Herceptin in vitro. Taxotere and Cisplatin have been shown to be an active combination in LABC. Twenty five pts with LABC that overexpress her-2(DAKO+2+3)were treated preoperatively with Herceptin 4 mg/kg Day 1 and 2mg/kg weekly × 11, Taxotere 70 mg/m2 and Cisplatin 70 mg/m2 Day 1,22,43&64,G-CSF 5ug/kg/d Day 2,23,44&65 until ANC>10,000/mm3 and Procrit 40,000u QW×12. Adjuvant therapy with AC×4 was given followed by radiation therapy and Tamoxifen. RESULTS:Clinical stages were as follows:Stage IIB(5 pts)Stage IIIA(14pts)StageIIIB(5pts)StageIV based on an ipsilateral supraclavicular node(1pt). Five pts had T4 lesions and four had N2 disease.Two had inflammatory cancer. The median largest tumor diameter was 8 cm. The mean age was 45 and one half of the pts were premenopausal. Sixteen pts have undergone surgery. The pathologic complete response rate(absence of invasive disease in breast and axilla)is 13%(2/16)with minimal residual disease(less than 1cm disease) in 19%(3/16). At surgery 63% (10/16) are node negative. The most common toxicities were hyperglycemia (80%), nausea/vomitting (76%),fatigue (68%)and anemia (68%). Grade III toxicities include hyperglycemia (40%) nausea/vomitting (6%) catheter infection (13%). Decrease in LVEF was seen in 50% (8/16)of the pts that completed the neoadjuvant therapy. These included two pts with Grade I (13%)five pts with Grade II (31%) and one pt with Grade III (6%). The combination of Herceptin, Taxotere and Cisplatin is a very active regimen in the neoadjuvant therapy of LABC and yields an unusually high rate of axillary node clearence.

Original languageEnglish (US)
Number of pages1
JournalBreast cancer research and treatment
Volume69
Issue number3
StatePublished - Dec 1 2001

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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