Journal of Clinical Oncology, Vol 17, Issue 7
(July), 1999: 1999
© 1999 American Society for Clinical Oncology
Maximized Reduction of Primary Breast Tumor Size Using Preoperative Chemotherapy With Doxorubicin and Docetaxel
Gunter von Minckwitz,
Serban Dan Costa,
Wolfgang Eiermann,
Jens-Uwe Blohmer,
Augustinos Harjanto Tulusan,
Christian Jackisch,
Manfred Kaufmann
From the Klinik für Gynäkologie und Geburtshilfe, Goethe-Universität Frankfurt, Frankfurt am Main; Frauenklinik vom Bayerischen Roten Kreuz, Munich; Frauenklinik der Charité, Humboldt-Universität zu Berlin, Berlin; Frauenklinik, Klinikum Bayreuth, Bayreuth; and Universitäts-Frauenklinik Münster, Münster, Germany.
Address reprint requests to Gunter von Minckwitz, MD, Klinik der Frauenheilkunde und Geburtshilfe, Goethe-Universität Frankfurt, Theodor-Stern Kai 7, D-60590 Frankfurt am Main, Germany; email minckwitz{at}em.uni-frankfurt.de
PURPOSE: To assess the toxicity and efficacy of preoperative chemotherapy with doxorubicin and docetaxel in patients with primary operable breast cancer.
PATIENTS AND METHODS: Forty-two patients with histologically confirmed primary breast cancer tumors of at least 2 cm in diameter received doxorubicin (50 mg/m2 intravenously [IV] over 15 minutes) and docetaxel (75 mg/m2 IV over 1 hour) every 14 (24 patients) or 21 (18 patients) days for four cycles.
RESULTS: The median size of the primary tumor decreased significantly, from 4 cm (range, 2 to 10 cm) to 2 cm (range, 0 to 5 cm) on physical examination and from 3.4 cm (range, 1 to 8 cm) to 1.8 cm (range, 0 to 4 cm) on sonography (P < .001). The overall response rate as assessed by physical examination was 93%, and complete remission of the primary tumor occurred in 33% of patients. The remission rate as assessed by sonographic measurement was 67%. Two patients (5%) had histologically confirmed complete responses. Sonography was more reliable than palpation in predicting histologically determined response. No grade 4 toxicity was noted, and grade 3 toxicity was reported with alopecia (95%), lethargy (17%), loss of appetite (10%), stomatitis (7%), leukopenia (5%), skin desquamation (5%), infection (5%), motor neuropathy (2%), and nausea (2%). The 3-week schedule was associated with less toxicity than the 2-week schedule.
CONCLUSION: Preoperative combination chemotherapy with doxorubicin and docetaxel is highly effective and feasible in primary operable breast cancer.
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