Author:
Liu Weifang,Chen Wei,Zhang Xiuxiang,Zhao Peng,Fan Zhimin,Bi Lirong,Wu Di,Li Sijie,Yang Ming,Fu Tong,Song Dong,Han Bing,Zhao Gang,Du Ye,Shi Aiping
Abstract
AbstractThe present study aimed to investigate the efficacy and toxicity of pegylated liposomal doxorubicin (PLD) in preoperative neoadjuvant chemotherapy for patients with breast cancer by comparing with conventional anthracycline. This study is a non-randomized controlled trial. Prospective analysis was conducted after matching as required. A total of 146 patients with confirmed diagnosis of breast cancer by histopathological examinations were enrolled into the observation group and control group in 1:1 ratio. Each of the cases in the observation group was required to correspond to another in the control group according to the requirements including age, molecular subtype, axillary node status, and regimen of the preoperative neoadjuvant chemotherapy. The chemotherapy was based on regimens consisting of anthracyclines, paclitaxel or docetaxel, and/or platinum. PLD was used at least twice in the observation group, with traditional anthracycline as a contrast in the control group. Clinical responses as well as cardiac side effects and other adverse reactions were evaluated by clinical and imaging examinations such as electrocardiogram (ECG) and color Doppler ultrasound during the chemotherapy. Pathologic examinations were performed following the surgeries after preoperative neoadjuvant chemotherapy. All the patients in both groups completed the preoperative neoadjuvant chemotherapy according to their original regimens. The postoperative pathological evaluation revealed a higher pathologic complete response (PCR) rate and significantly more patients of grade V of the Miller-Payne grading system in the observation group as compared to the control group (p = 0.047). In addition, the observation group recorded an evidently lower occurrence of the adverse cardiac events (p = 0.014), ECG changes (p = 0.048), and the relatively severe adverse reactions such as myelosuppression. Compared with conventional anthracycline drugs, PLD has a better pathologic response and safety performance, as well as a similar clinical effectiveness in preoperative neoadjuvant chemotherapy for breast cancer.
Publisher
Springer Science and Business Media LLC
Reference19 articles.
1. Siegel, R. et al. Cancer statistics, 2014. CA Cancer J. Clin. 64(1), 9–29 (2014).
2. Curigliano, G. et al. De-escalating and escalating treatments for early-stage breast cancer: The St. Gallen International Expert Consensus Conference on the Primary Therapy of Early Breast Cancer 2017. Ann. Oncol. 28, 1700–1712. https://doi.org/10.1093/annonc/mdx308 (2017).
3. Bear, H. D. et al. Sequential preoperative or postoperative docetaxel added to preoperative doxorubicin plus cyclophosphamide for operable breast cancer National Surgical Adjuvant Breast and Bowel Project Protocol B—27. J. Clin. Oncol. 24, 24019–24202 (2006).
4. Kaufmannm, M. et al. Recommendations from an international expert panel on the use of neoadjuvant (primary) systemic treatment of operable breast cancer: An update. J. Clin. Oncol. 24, 1940–1949 (2006).
5. Bird, B. R. & Swain, S. M. Cardiac toxicity in breast cancer survivors: Review of potential cardiac problems. Clin. Cancer Res. 14(1), 14–24 (2008).
Cited by
9 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献