Response to neoadjuvant chemotherapy and hormonotherapy in Chinese women with breast cancer

Abstract

OBJECTIVES: There is an increase use of neoadjuvant chemo-hormonotherapy in the management of breast cancer in the past years. A variety of treatment regimens resulted in different efficacy and tolerability. This study aims to review the local experience of using such modality in a university breast surgical center. METHODS: A retrospective study of patients with breast cancer who received neoadjuvant chemotherapy or hormonal therapy followed by definitive surgery from January 2002 to December 2006 was performed. RESULTS: 91 patients received neoadjuvant chemotherapy during the study period. 53 patients received anthracycline-based regimen (AC only), 37 patients anthracycline and taxane-based regimen (AC + T) and 1 patient had additional Trastuzumab after receiving anthracycline and taxane (AC + TH). The pathologic complete response rates of AC only, AC + T and AC + TH were 9.4% (5/53), 24.3% (9/37) and 100.0% (1/1), respectively. Number of cycles and tumor size were significant factors affecting the pCR rate after neoadjuvant chemotherapy. Grade 4 toxicity was observed in 12.2% of patients during AC treatment and in 15.8% of patients during docetaxel treatment. 81 patients received aromatase inhibitors (AI) as neoadjuvant hormonal therapy. The pCR rate of AI was 1.2% (1/81) and none of the patients experienced grade 3 or 4 toxicity. CONCLUSIONS: The efficacy and tolerability of neoadjuvant therapy are similar in our population as compared with the Western countries. Neoadjuvant chemotherapy could achieve a higher response rate but neoadjuvant hormonotherapy was better tolerated.