The efficacy and feasibility of dose-dense sequential chemotherapy for Japanese patients with breast cancer

Daisuke Takabatake, Yukiko Kajiwara, Shoichiro Ohtani, Yoko Itano, Mari Yamamoto, Shinichiro Kubo, Masahiko Ikeda, Mina Takahashi, Fumikata Hara, Kenjiro Aogi, Shozo Ohsumi, Yutaka Ogasawara, Yoshitaka Nishiyama, Hajime Hikino, Kinya Matsuoka, Yuko Takahashi, Tadahiko Shien, Naruto Taira, Hiroyoshi Doihara

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Abstract

Background Perioperative dose-dense chemotherapy (DDCT) with granulocyte-colony stimulating factor (G-CSF) prophylaxis is a standard treatment for patients with high-risk breast cancer. The approval of this approach in Japan led to the widespread adoption of DDCT, despite limited efficacy and safety data among Japanese patients. We evaluated the efficacy and safety of neoadjuvant DDCT for Japanese patients with breast cancer. Methods This prospective, multicenter, phase II study evaluated 52 women with operable human epidermal growth factor receptor 2-negative breast cancer and axillary lymph node metastasis. Neoadjuvant DDCT (adriamycin plus cyclophosphamide or epirubicin plus cyclophosphamide followed by paclitaxel) was administrated every 2 weeks with G-CSF support. The study endpoints were the rates of pathological complete response (pCR), febrile neutropenia, treatment completion, toxicities, and the relative dose intensity (RDI). Results The pCR rate was 21.9% (9/41) and the triple-negative (TN) subtype was significantly associated with a high pCR rate (triple-negative: 53.3% vs. luminal A: 7.7% and luminal B: 0%; p = 0.003). The treatment completion rate was 80.8% (42/52) and the average RDI was 98.9%. Most adverse events were manageable and tolerable. Six patients (11.5%) developed febrile neutropenia. Grade 3-4 adverse events were slightly more common among older patients (57%) with a low protocol completion rate (≥ 65 years: 42.9% vs. <65 years: 86.7%, p = 0.0062). Conclusion The pCR rate for DDCT was similar to that of standard chemotherapy, although it was remarkably effective for the TN subtype. DDCT may be feasible for Japanese patients with breast cancer although caution is needed for older patients.

Original languageEnglish
Pages (from-to)717-722
Number of pages6
JournalBreast Cancer
Volume25
Issue number6
DOIs
Publication statusPublished - Jan 1 2018

Keywords

  • Breast cancer
  • Dose-dense chemotherapy
  • Feasibility
  • Japanese
  • Neoadjuvant

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Pharmacology (medical)

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  • Cite this

    Takabatake, D., Kajiwara, Y., Ohtani, S., Itano, Y., Yamamoto, M., Kubo, S., Ikeda, M., Takahashi, M., Hara, F., Aogi, K., Ohsumi, S., Ogasawara, Y., Nishiyama, Y., Hikino, H., Matsuoka, K., Takahashi, Y., Shien, T., Taira, N., & Doihara, H. (2018). The efficacy and feasibility of dose-dense sequential chemotherapy for Japanese patients with breast cancer. Breast Cancer, 25(6), 717-722. https://doi.org/10.1007/s12282-018-0877-1