102P - Adriamycin/taxanes based neoadjuvant chemotherapy in advanced non-metastatic breast cancer – A single institute experience

Date 18 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Cytotoxic agents
Breast Cancer, Locally Advanced
Presenter Hifza Yasmeen
Citation Annals of Oncology (2016) 27 (suppl_9): ix30-ix34. 10.1093/annonc/mdw576
Authors H. Yasmeen, A.I. Masood
  • Radiation Oncology, Nishter Hospital, 13014 - Multan/PK

Abstract

Background

Pakistan has the highest rate of breast cancer for any South Asian population and majority of patients present with locally advanced or metastatic disease. We report on response and survival of primary locally advanced non-metastatic breast cancer in women treated with neoadjuvant Adriamycin/Taxanes (AT) based regimens at our institute.

Methods

Between 2010 to 2015, we retrospectively identified 417 women with pathologically confirmed locally advanced breast cancer. All patients received neoadjuvant chemotherapy with AT based regimen followed by surgery. Median age was 46 years (range 15-69 years). AJCC stage; stage II 56%, stage III 44%. Axillary nodes were palpable in 76% of the patients at presentation. Histological sub-types were infiltrating ductal carcinoma 94%, infiltrating lobular carcinoma 4% and others 2% respectively. Pathological grade was I/II in 48% and grade III 52% of the patients. ER, PR, and Her2-neu receptors were positive in 44%, 40% and 24% respectively. 26% of the patients had triple negative breast cancer. Post operative radiotherapy was delivered to 91% of the patients. Patients with positive ER/PR receptors also received hormonal manipulation.

Results

Following neo-adjuvant chemotherapy, pathological response was; complete response (CR) 14%, partial response 21%, stable disease 52% and progressive disease in 13% of the patients respectively. Breast conservation was possible in 32% of the patients. The 5 year overall survival (OS) and disease free survival (DFS) in patients with CR was 77% and 81% respectively. The 5 year OS and DFS in patients without CR was 46% and 42% respectively. On multivariate analysis T stage (p = 0.001) and response to neo-adjuvant chemotherapy (p = 0.001) were found to be independent predictors for OS and DFS.

Conclusions

Pathological response to neoadjuvant chemotherapy is a predictor of long term survival. Chemotherapy regimens with high response rates merit evaluation in randomized trials to improve outcome in locally advanced breast cancer.

Clinical trial indentification

Legal entity responsible for the study

N/A

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.