Premium
Inflammatory breast cancer outcome with epirubicin‐based induction and maintenance chemotherapy
Author(s) -
Veyret Corinne,
Levy Christelle,
Chollet Philippe,
Merrouche Yacine,
Roche Henri,
Kerbrat Pierre,
Fumoleau Pierre,
Fargeot Pierre,
Clavere Pierre,
Chevallier Bernard
Publication year - 2006
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.22227
Subject(s) - epirubicin , medicine , cyclophosphamide , regimen , induction chemotherapy , surgery , fluorouracil , chemotherapy , breast cancer , gastroenterology , cancer
BACKGROUND. The authors evaluated the long‐term efficacy and side effects in patients with nonmetastatic, unilateral, inflammatory breast cancer (IBC) who received homogeneous treatment with intensive induction chemotherapy followed by a maintenance regimen. METHODS. One hundred twenty patients were randomized to receive high‐dose fluorouracil, epirubicin, and cyclophosphamide (FEC‐HD) (fluorouracil 750 mg/m 2 on Days 1 to 4, epirubicin 35 mg/m 2 on Days 2 to 4, and cyclophosphamide 400 mg/m 2 on Days 2 to 4 for 4 cycles every 21 days) with or without lenograstim. Locoregional treatment consisted of surgery and/or radiotherapy. Maintenance chemotherapy was FEC 75 (fluorouracil 500 mg/m 2 , epirubicin 75 mg/m 2 , and cyclophosphamide 500 mg/m 2 on Day 1 every 21 days for 4 cycles). No hormone treatment was allowed. RESULTS. The safety of the FEC‐HD regimen was described previously. Among 102 patients who underwent surgery, a pathologic complete response (pCR) was achieved by 23.5% of patients with breast tumors and by 31.4% of patients with involved axillary lymph nodes. The overall pCR rate was 14.7%. One hundred nine patients received FEC 75. After a median 10 years of follow‐up, the disease‐free survival (DFS) and overall survival (OS) rates were 35.7% and 41.2%, respectively. The median DFS was 39 months (95% confidence interval [95% CI], 25–53 months), and the median survival was 61 months (95% CI, 43–79 months). Five patients developed a temporary decrease in left ventricular ejection fraction without congestive heart failure. In the lenograstim group, 1 patient developed acute myeloblastic leukemia M2, and 1 patient developed myelodysplastic syndrome. CONCLUSIONS. FEC‐HD induction chemotherapy followed by FEC 75 maintenance regimen had moderate and acute long‐term toxicities and lead to high DFS and OS rates in patients with IBC. Cancer 2006. © 2006 American Cancer Society.