Sequential administration of dose-dense epirubicin/cyclophosphamide followed by docetaxel/capecitabine for patients with HER2-negative and locally advanced or node-positive breast cancer

Abstract

Capecitabine is effective against metastatic breast cancer (MBC). We hypothesized that sequential treatment with dose-dense epirubicin/cyclophosphamide (EC) and docetaxel/capecitabine would be active and tolerable in the adjuvant/neoadjuvant setting. In this prospective phase II clinical trial patients with HER2-negative and node-positive or locally advanced tumors were eligible to receive four cycles of EC (100/600 mg/m2) every 2 weeks with G-CSF on days 3–10, followed by four cycles of docetaxel/capecitabine (75/1,000 mg/m2 b.i.d., days 1–14) every 3 weeks. Fifty-five patients were enrolled with median age of 49, and 80% had hormone receptor-positive disease. The median tumor size was 2.5 cm, with a median of two axillary nodes involved. Seventy-five percent of the first 20 patients had grade 2/3 hand-foot syndrome (HFS). Dose reduction of capecitabine to 800 mg/m2 reduced the grade 2/3 HFS incidence to 31% in the remaining patients. No grade 4/5 toxicities were observed. All 20 patients treated preoperatively responded, with 5 (25%) pathologic complete responses and 3 additional pT0N1 tumors. At a median follow-up of 48 (range 28–60) months, the event-free and overall survival rates are 91 and 98%, respectively. Sequential treatment with dose-dense EC followed by docetaxel/capecitabine, using a lower capecitabine dose than that approved for MBC, has an acceptable toxicity profile and encouraging activity when used as neoadjuvant or adjuvant treatment of breast cancer.

DOI: 10.1007/s00280-009-1049-y

3 Figures and Tables

Statistics

01000200020102011201220132014201520162017
Citations per Year

245 Citations

Semantic Scholar estimates that this publication has 245 citations based on the available data.

See our FAQ for additional information.

Cite this paper

@article{Nieto2009SequentialAO, title={Sequential administration of dose-dense epirubicin/cyclophosphamide followed by docetaxel/capecitabine for patients with HER2-negative and locally advanced or node-positive breast cancer}, author={Yago L. Nieto and Jos{\'e} Manuel Aramend{\'i}a and Jaime Espin{\'o}s and Susana de la Cruz and {\'O}scar Fern{\'a}ndez-Hidalgo and Marta Santisteban and Leyre Arbea and Jos{\'e} Javier Aristu and Rafael Mart{\'i}nez-Monge and Marta Nieto Moreno and Luis Javier Pina and Josu Sola and Gerardo Zornoza and Fernando Mart{\'i}nez Regueira}, journal={Cancer Chemotherapy and Pharmacology}, year={2009}, volume={65}, pages={457-465} }