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Survival outcomes of neoadjuvant chemotherapy with zoledronic acid for HER2-negative breast cancer.
- Source :
-
The Journal of surgical research [J Surg Res] 2017 Dec; Vol. 220, pp. 46-51. Date of Electronic Publication: 2017 Jul 26. - Publication Year :
- 2017
-
Abstract
- Background: A randomized phase 2 trial in women with HER2-negative breast cancer has shown that adding zoledronic acid (ZOL) to neoadjuvant chemotherapy (CT) has potential anticancer benefits in postmenopausal and triple-negative (TN) breast cancer patients. We report the data for the secondary end point of disease-free survival (DFS).<br />Methods: Patients were randomly assigned to receive CT or CT + ZOL (CT-Z). All patients received four cycles of FEC100 followed by 12 cycles of paclitaxel weekly. ZOL (4 mg) was administered 3-4 times weekly for 7 wk to the CT-Z group patients. The primary end point was pathologic complete response (pCR). The secondary end points were the clinical response rates, rate of breast-conserving surgery, safety, and DFS.<br />Results: Of the 188 patients enrolled, 95 were assigned to the CT group and 93 to the CT-Z group. DFS and overall survival were analyzed in 92 and 88 patients with the mean times of 5.15 y and 5.38 y, respectively. The 3-y DFS rate was 84.6% in the CT group and 90.8% in the CT-Z group (P = 0.188). The particular benefit from ZOL for the neoadjuvant CT seen as improvement of the pCR rate was indicated in the 3-y DFS period for TN cancer cases (CT versus CT-Z: 70.6% versus 94.1%) but not for postmenopausal cases.<br />Conclusions: ZOL did not improve DFS when combined with CT. However, the improvement of the pCR rate translated to survival outcomes in TN breast cancer. The short-term application of ZOL may not be sufficient to improve the outcome in postmenopausal patients.<br /> (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Subjects :
- Antineoplastic Combined Chemotherapy Protocols adverse effects
Breast Neoplasms pathology
Breast Neoplasms surgery
Cyclophosphamide adverse effects
Cyclophosphamide therapeutic use
Diphosphonates adverse effects
Disease-Free Survival
Epirubicin adverse effects
Epirubicin therapeutic use
Female
Fluorouracil adverse effects
Fluorouracil therapeutic use
Follow-Up Studies
Humans
Imidazoles adverse effects
Mastectomy, Segmental
Neoadjuvant Therapy adverse effects
Paclitaxel adverse effects
Paclitaxel therapeutic use
Postmenopause
Receptor, ErbB-2 metabolism
Zoledronic Acid
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Breast Neoplasms drug therapy
Breast Neoplasms mortality
Diphosphonates therapeutic use
Imidazoles therapeutic use
Neoadjuvant Therapy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1095-8673
- Volume :
- 220
- Database :
- MEDLINE
- Journal :
- The Journal of surgical research
- Publication Type :
- Academic Journal
- Accession number :
- 29180210
- Full Text :
- https://doi.org/10.1016/j.jss.2017.05.066