Adjuvant Dose-Dense Sequential Chemotherapy with Epirubicin, CMF and Weekly Paclitaxel in Patients with Resected High-Risk Breast Cancer: A Hellenic Cooperative Oncology Group (HeCOG) Study

Department of Clinical Therapeutics, Alexandra Hospital, University of Athens School of Medicine, Athens,
Cancer Investigation (Impact Factor: 2.22). 07/2008; 26(5):491-8. DOI: 10.1080/07357900701829785
Source: PubMed


Randomized phase III trials have demonstrated that the addition of paclitaxel is effective in the adjuvant treatment of breast cancer. Forty-five patients with high-risk resected breast cancer entered this study. They were treated with three cycles of epirubicin every 2 weeks, followed by three cycles of intensified CMF, every 2 weeks, followed 3 weeks later by nine weekly cycles of paclitaxel (E-CMF-T). Forty patients (89%) received all cycles of chemotherapy and dose intensity was sufficiently maintained for all drugs. Toxicity was generally mild to moderate. Two cases of febrile neutropenia were reported. The E-CMF-T regimen is feasible and well tolerated.

3 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Nearly 30% of breast cancer cases present in women younger than 50 years old. While newer treatment regimens employed are less gonadotoxic, regimens still consist of combination medications that include cyclophosphamide, known to deplete the number of primordial follicles, thereby potentially leading to infertility. For common regimens such as adriamycin/cytoxan (AC), the risk of premature ovarian failure was thought to be largely dependent on patient age, with the risk of complete ovarian failure <10% in women <30, and nearly 100% in women >40 (Hortobagyi et al. (1986) [1]); however recent studies indicate that AC is considered to have intermediate risk for gonadotoxicity in women >40 years age. This review examines major strides in the field of reproductive medicine over the past 20 years including the use of leuprolide acetate, embryo cryopreservation, oocyte cryopreservation and ovarian tissue banking. We also discuss the role of gestational carriers and adoption in establishing families as a viable option for many of these cancer patients who may be unable to avail themselves of other alternatives to fertility preservation.
    Critical reviews in oncology/hematology 03/2010; 74(3):175-92. DOI:10.1016/j.critrevonc.2009.09.006 · 4.03 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Incidence of endometrial carcinoma, the most common malignancy of the female pelvis, has been steadily increasing during the last three decades. The prognosis for stage IVb cases with extra-abdominal metastases is extremely poor, with no current consensus regarding treatment. The aim of the present study was to examine the benefits of cytoreductive surgery for such cases. Clinicopathological features of 33 stage IVb cases of endometrial carcinoma diagnosed during the 1991-2008 study period were retrospectively reviewed utilizing clinical records. Cytoreduction was conducted in 30 cases. The median progression-free survival (PFS) and overall survival (OS) of those patients with optimal cytoreduction of their disease (with residual masses < or =2 cm), were significantly better than those with suboptimal reduction (with residual masses > 2 cm), not only among the 15 stage IVb patients with only intra-abdominal metastasis (group I) (P = 0.0003 and 0.0007) but also among the 15 cases with extra-abdominal metastasis (group E) (P = 0.013 and 0.016). Multivariate Cox proportional-hazards analysis demonstrated that the adjusted hazard ratio (HR) for the maximum size of residual disease (>2 vs. < or =2 cm) was 10.4 [95% confidence interval (CI), 1.27-84.70, P = 0.030] in group I and 16.92 (95% CI, 1.41-203.09, P = 0.026) in group E. This is the first demonstration that aggressive cytoreductive surgery for stage IVb endometrial carcinoma with extra-abdominal metastasis has a beneficial role. However, further investigation is still required to establish better standard therapy for stage IVb endometrial cancer.
    Annals of Surgical Oncology 04/2010; 17(4):1111-7. DOI:10.1245/s10434-009-0892-8 · 3.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Within the last several decades adjuvant polychemotherapy for breast cancer has evolved with the development of anthracyclines and taxanes. Parallel to these developments, granulocyte-colony stimulating factor support has permitted the safe delivery of chemotherapy at shorter ('dose-dense') intertreatment intervals, which, as predicted by preclinical models, has further improved survival. Recently, insights into tumor biology have led the development of targeted therapies, such as trastuzumab for HER2-positive disease, and this has now been successfully incorporated into dose-dense therapy. Newer targeted agents may be similarly incorporated into dose-dense regimens to further improve patient outcomes. This article reviews dose-dense therapy and discusses its role as a chemotherapy foundation for additional targeted agents.
    Future Oncology 06/2010; 6(6):951-65. DOI:10.2217/fon.10.59 · 2.48 Impact Factor
Show more

Similar Publications