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Weekly Docetaxel as Neoadjuvant Chemotherapy for Stage II and III Breast Cancer

Efficacy and Correlation with Biological Markers in a Phase II, Multicenter Study¹

Fundación Jiménez Díaz, 28040 Madrid [L. G. E., F. L., J. Fo.]; Hospital de la Ribera, Valencia [J. M. C.]; Hospital Universitario Miguel Servet, Zaragoza [A. A., A. H.]; Hospital de Barbastro, Huesca [J. Fl.]; Hospital Marqués de Valdecilla, Santander [J. M. L-V.]; and Hospital de la Princesa, Madrid [A. V.], Spain

Purpose: This is one of the first reports of weekly docetaxel (Taxotere) in the neoadjuvant treatment of stage II and III breast cancer. We evaluated docetaxel’s efficacy and safety and analyzed correlations between response and the expression of c-erbB2, ER status, and Ki-67 labeling index.

Experimental Design: Patients with previously untreated, stage II and III breast cancer were entered into the study. Docetaxel (40 mg/m²) was given i.v. once weekly for the first 6 weeks of an 8-week cycle for 2 cycles.

Results: A total of 56 patients were evaluated by intention-to-treat analysis for efficacy and safety. The overall clinical response rate was 68% (complete and partial response, 29 and 39%, respectively). Nine patients (16%) achieved a pathological complete response. There was no correlation between response to docetaxel and the expression of molecular markers, however, the majority of the pathological complete responses were observed in patients with c-erbB2-negative tumors. Nonhematological toxicity was more common than hematological toxicity, with alopecia and asthenia the most frequently reported adverse events (89 and 77% of patients, respectively). Severe hematological toxicity was rare.

Conclusions: Weekly docetaxel appears to be very effective in the neoadjuvant setting. A high pathological response rate was achieved with tolerable toxicity.

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