Análisis de la efectividad del tratamiento neoadyuvante al añadir docetaxel secuencial a fluorouracilo, epirrubicina y ciclofosfamida en pacientes con cáncer de marna avanzado: Resultados preliminares de respuesta tumoral

Objective: Retrospective study, designed to assess the effectiveness and tolerability of docetaxel sequential to epirubicin as neoadjuvant systemic therapy (NST) in women with locally advanced breast cancer (LABC). Patients and Methods: A total of 126 LABC-diagnosed patients were included (70 stage IIIA; 53 stage IIIB; 3 stage IIIC). The patients received FEC (500 mg/m², 75 mg/m², 500 mg/m², respectively) every 3 weeks for 4 cycles, followed by docetaxel 75 mg/m² every 3 weeks for 4 cycles. Surgery was performed at the end of the chemotherapy. Results: In the analysis of the 4FEC-4D scheme by groups, a significant increase in clinical complete response (cCR) was observed when docetaxel was added to preoperative FEC (Wilcoxon test, z = -2.35; P =.019). An objective response rate (ORR) of 78.5% (95% confidence interval [95% CI], 71.4 - 85.7) and pathological complete response (pCR) of 30.2% (95% CI, 22.2 - 38.2) were obtained. In the pCR group, tumors with stage IIIA lower nuclear grade and ER-positiveness showed higher response to NST (71.1%, 84.2% and 61.7%, respectively). The proportion of patients with negative lymph nodes was 51.6%. (95% CI: 42.9 - 60.3). The FEC regimen had more severe emetic effects, such as nausea (3.3%) and vomiting (2.1%). The docetaxel regimen produced severe toxicities, including myalgia (2.0%), fatigue (1.4%), and peripheral sensory neuropathy (0.4%). Conclusion: This study showed that the sequential addition of standard-dose docetaxel to FEC is highly active, feasible and well tolerated in patients with LABC.