Superior outcome after neoadjuvant chemotherapy with docetaxel, anthracycline, and cyclophosphamide versus docetaxel plus cyclophosphamide: results from the NATT trial in triple negative or HER2 positive breast cancer

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• 作者：Xiaosong Chen (1)
  Guolin Ye (2)
  Chenfang Zhang (3)
  Xinzheng Li (4)
  Yiding Chen (5)
  Xiaohong Xie (6)
  Hong Zheng (7)
  Yali Cao (8)
  Kejin Wu (9)
  Duo Ni (10)
  Jinhai Tang (11)
  Ziguo Wei (12)
  Kunwei Shen (1)
  
• 关键词：Triple negative breast cancer ; Neoadjuvant chemotherapy ; Anthracycline ; Pathological complete remission ; Prognosis ; HER2 positive breast cancer
• 刊名：Breast Cancer Research and Treatment
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：142
• 期：3
• 页码：549-558
• 全文大小：
• 作者单位：Xiaosong Chen (1)
  Guolin Ye (2)
  Chenfang Zhang (3)
  Xinzheng Li (4)
  Yiding Chen (5)
  Xiaohong Xie (6)
  Hong Zheng (7)
  Yali Cao (8)
  Kejin Wu (9)
  Duo Ni (10)
  Jinhai Tang (11)
  Ziguo Wei (12)
  Kunwei Shen (1)
  
  1. Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
  2. Department of Breast Surgery, The First People Hospital of Foshan, Foshan, Guangdong, China
  3. Department of Breast Surgery, Guangzhou General Hospital of Guangzhou Military Area, Guangzhou, Guangdong, China
  4. Department of Breast Surgery, Shanxi Provincial Cancer Hospital, Taiyuan, Shanxi, China
  5. Department of Breast Surgery, Obstetrics and Gynecology Hospital Affiliated to Zhejiang University, Hangzhou, Zhejiang, China
  6. Department of Breast Surgery, Zhejiang Traditional Chinese Medical Hospital, Hangzhou, Zhejiang, China
  7. Department of Breast Surgery, West China Hospital Sichuan University, Chengdu, Sichuan, China
  8. Department of Breast Surgery, The Third Hospital of Nanchang, Nanchang, Jiangxi, China
  9. Department of Breast Surgery, Xin Hua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
  10. Department of Breast Surgery, Xinjiang Uygur Autonomous Region Cancer Hospital, Xinjiang, China
  11. Department of Breast Surgery, Jiangsu Cancer Hospital, Nanjing, Jiangsu, China
  12. Department of Breast and Thyroid Surgery, Linyi People Hospital, Linyi, Shandong, China
  
• ISSN：1573-7217

文摘

The purpose of this study is to evaluate the efficacy and safety of docetaxel plus cyclophosphamide (TC) compared with docetaxel, anthracycline, and cyclophosphamide (TEC) in neoadjuvant treatment of triple negative or HER2 positive breast cancer. Eligible breast cancer patients were randomized to receive six cycles of TC or TEC. The primary end point was pathological complete remission (pCR). Secondary end points included safety, clinical response rate, and survival outcome. One hundred and two patients were initially randomized and 96 patients were available for efficacy analysis. 96.9% patients were treated with epirubicin as an anthracycline agent. pCR rates were 6.8% (3/45) and 17.6% (9/51) in TC and TEC group, respectively, P=0.113. After a mean follow up of 20 (36) months, non-anthracycline-containing TC regimen treatment resulted in a worse event-free survival (adjusted hazard ratio [HR] 2.42; 95% CI 1.11.30) and disease-free survival (HR 2.85; 95% CI 1.21.74) compared with TEC regimen, which was more apparent in triple negative subtype. Severe adverse event rates were similar, except that patients treated with TEC had a higher rate of neutropenia and leucopenia. TEC treatment had a superior survival outcome and trend of higher pCR rate compared with TC in this trial setting, especially in triple negative subtype, which deserves further validation.