gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Subgroup analysis of 101 inflammatory breast cancer patients treated within a prospective randomized trial of dose dense sequential versus standard anthracycline- and taxane- based primary chemotherapy (multicentre study of the AGO)

Meeting Abstract

  • corresponding author presenting/speaker Nina Ditsch - LMU München, Klinikum Großhadern , Deutschland
  • Ingo Bauerfeind - LMU München, Klinikum Großhadern
  • Steffen Kahlert - LMU München, Klinikum Großhadern
  • Miriam Lenhard - LMU München, Klinikum Großhadern
  • Isabelle Himsl - LMU München, Klinikum Großhadern
  • Klaus Friese - LMU München, Klinikum Großhadern
  • Michael Untch - LMU München, Klinikum Großhadern

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPO012

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dkk2006/06dkk122.shtml

Veröffentlicht: 20. März 2006

© 2006 Ditsch et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction: Neoadjuvant chemotherapy is long established as part of the multimodality management of inflammatory breast cancer. Data from the literature showed improved disease free survival by increasing dose density and shortening of intervals. The design of this study was selected to evaluate pCR rates, frequency of breast conserving surgery, side effects and outcome of Epirubicin (E)/Paclitaxel (T) as either dose-dense sequential regimen (Arm A) or as standard chemotherapy (Arm B).

Patients and methods: Subgroup analysis contains 101 patients with inflammatory type out of 679 breast cancer patients diagnosed between 1998 and 2002. Patients were randomized to receive 3xE 150 mg/m2 followed by 3xT 250 mg/m2 q2w with G-CSF (Filgrastim) support (5mg/kg/d, d3-10) (Arm A) or 4xET 90/175 mg/m2 q3w (Arm B) as preoperative therapy. All patients received 3xCMF q4w (500/40/600 mg/m2 d1+8) after surgery, radiation and antihormonal therapy if indicated.

Results: Data from 93 patients on response at surgery are available (A n=42, B n=51). Demographic characteristics are equally balanced between both groups. In 20 patients planned for mastectomy primary systemic therapy rendered a breast conserving therapy. Clinical downstaging of tumor size was possible in 43%, also in nodalstatus in 26%. Pathologic complete response rate was in favour of the dose dense arm (21% vs 12%). Both regimens were well tolerated. Patients with IBC show a significant higher rate of relapses than patients without IBC, despite optimal preoperative chemotherapy.

Conclusion and discussion: Our study support data on IBC as rapidly progressive disease with poor prognosis compared to other types of breast cancer. Clinical and pathologic response showed a benefit in favour of the dose-dense sequential chemotherapy, but patients with inflammatory breast cancer have a poor prognosis independent of pcR rate and irrespective of treatment schedule at the time of this analysis. Normally IBC is regarded as disease with a contraindication for breast conserving therapy. Our analysis show that in about one quarter of the patients breast conserving therapy was possible without elevated rates of secondary surgeries.