Long-term survival of advanced triple-negative breast cancers with a dose-intense cyclophosphamide/anthracycline neoadjuvant regimen - HAL Accéder directement au contenu
Article dans une revue British Journal of Cancer Année : 2014

Long-term survival of advanced triple-negative breast cancers with a dose-intense cyclophosphamide/anthracycline neoadjuvant regimen

S. Giacchetti
R. Porcher
  • Fonction : Auteur
J. Lehmann-Che
  • Fonction : Auteur
A. S. Hamy
  • Fonction : Auteur
A. De Roquancourt
  • Fonction : Auteur
C. Cuvier
  • Fonction : Auteur
P. H. Cottu
P. Bertheau
  • Fonction : Auteur
M. Albiter
  • Fonction : Auteur
F. Bouhidel
  • Fonction : Auteur
F. Coussy
  • Fonction : Auteur
J. M. Extra
  • Fonction : Auteur
M. Marty
  • Fonction : Auteur
M. Espie

Résumé

BACKGROUND: Triple-negative (TN) breast cancers exhibit major initial responses to neoadjuvant chemotherapy, but generally have a poor outcome. Because of the lack of validated drug targets, chemotherapy remains an important therapeutic tool in these cancers. METHODS: We report the survival of two consecutive series of 267 locally advanced breast cancers (LABC) treated with two different neoadjuvant regimens, either a dose-dense and dose-intense cyclophosphamide-anthracycline (AC) association (historically called SIM) or a conventional sequential association of cyclophosphamide and anthracycline, followed by taxanes (EC-T). We compared pathological responses and survival rates of these two groups and studied their association with tumours features. RESULTS: Although the two regimens showed equivalent pathological complete response (pCR) in the whole population (16 and 12%), the SIM regimen yielded a non-statistically higher pCR rate than EC-T (48% vs 24%, P=0.087) in TN tumours. In the SIM protocol, DFS was statistically higher for TN than for non-TN patients (P=0.019), although we showed that the TN status was associated with an increased initial risk of recurrence in both regimens. This effect gradually decreased and after 2 years, TN was associated with a significantly decreased likelihood of relapse in SIM-treated LABC (hazard ratio (HR)=0.25 (95% CI: 0.07-0.86), P=0.028). CONCLUSIONS: AC dose intensification treatment is associated with a very favourable long-term survival rate in TN breast cancers. These observations call for a prospective assessment of such dose-intense AC-based regimens in locally advanced TN tumours.

Domaines

Cancer
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Dates et versions

hal-03653840, version 1 (08-01-2024)

Licence

Paternité - CC BY 4.0

Identifiants

Citer

S. Giacchetti, R. Porcher, J. Lehmann-Che, A. S. Hamy, A. De Roquancourt, et al.. Long-term survival of advanced triple-negative breast cancers with a dose-intense cyclophosphamide/anthracycline neoadjuvant regimen. British Journal of Cancer, 2014, 110 (6), pp.1413-9. ⟨10.1038/bjc.2014.81⟩. ⟨hal-03653840⟩
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