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

Research output: Contribution to journalArticle

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)1-6
Number of pages6
JournalBreast Cancer
DOIs
Publication statusAccepted/In press - Jun 11 2018

Fingerprint

Breast Neoplasms
Drug Therapy
Febrile Neutropenia
Granulocyte Colony-Stimulating Factor
Cyclophosphamide
Safety
Epirubicin
Paclitaxel
Doxorubicin
Japan
Therapeutics
Lymph Nodes
Neoplasm Metastasis

Keywords

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

ASJC Scopus subject areas

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

Cite this

The efficacy and feasibility of dose-dense sequential chemotherapy for Japanese patients with breast cancer. / Takabatake, Daisuke; Kajiwara, Yukiko; Ohtani, Shoichiro; Itano, Yoko; Yamamoto, Mari; Kubo, Shinichiro; Ikeda, Masahiko; Takahashi, Mina; Hara, Fumikata; Aogi, Kenjiro; Ohsumi, Shozo; Ogasawara, Yutaka; Nishiyama, Yoshitaka; Hikino, Hajime; Matsuoka, Kinya; Takahashi, Yuko; Shien, Tadahiko; Taira, Naruto; Doihara, Hiroyoshi.

In: Breast Cancer, 11.06.2018, p. 1-6.

Research output: Contribution to journalArticle

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, pp. 1-6. https://doi.org/10.1007/s12282-018-0877-1
Takabatake, Daisuke ; Kajiwara, Yukiko ; Ohtani, Shoichiro ; Itano, Yoko ; Yamamoto, Mari ; Kubo, Shinichiro ; Ikeda, Masahiko ; Takahashi, Mina ; Hara, Fumikata ; Aogi, Kenjiro ; Ohsumi, Shozo ; Ogasawara, Yutaka ; Nishiyama, Yoshitaka ; Hikino, Hajime ; Matsuoka, Kinya ; Takahashi, Yuko ; Shien, Tadahiko ; Taira, Naruto ; Doihara, Hiroyoshi. / The efficacy and feasibility of dose-dense sequential chemotherapy for Japanese patients with breast cancer. In: Breast Cancer. 2018 ; pp. 1-6.
@article{2aa3aab0f5fe4730937dbe4cc309d688,
title = "The efficacy and feasibility of dose-dense sequential chemotherapy for Japanese patients with breast cancer",
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.",
keywords = "Breast cancer, Dose-dense chemotherapy, Feasibility, Japanese, Neoadjuvant",
author = "Daisuke Takabatake and Yukiko Kajiwara and Shoichiro Ohtani and Yoko Itano and Mari Yamamoto and Shinichiro Kubo and Masahiko Ikeda and Mina Takahashi and Fumikata Hara and Kenjiro Aogi and Shozo Ohsumi and Yutaka Ogasawara and Yoshitaka Nishiyama and Hajime Hikino and Kinya Matsuoka and Yuko Takahashi and Tadahiko Shien and Naruto Taira and Hiroyoshi Doihara",
year = "2018",
month = "6",
day = "11",
doi = "10.1007/s12282-018-0877-1",
language = "English",
pages = "1--6",
journal = "Breast Cancer",
issn = "1340-6868",
publisher = "Springer Japan",

}

TY - JOUR

T1 - The efficacy and feasibility of dose-dense sequential chemotherapy for Japanese patients with breast cancer

AU - Takabatake, Daisuke

AU - Kajiwara, Yukiko

AU - Ohtani, Shoichiro

AU - Itano, Yoko

AU - Yamamoto, Mari

AU - Kubo, Shinichiro

AU - Ikeda, Masahiko

AU - Takahashi, Mina

AU - Hara, Fumikata

AU - Aogi, Kenjiro

AU - Ohsumi, Shozo

AU - Ogasawara, Yutaka

AU - Nishiyama, Yoshitaka

AU - Hikino, Hajime

AU - Matsuoka, Kinya

AU - Takahashi, Yuko

AU - Shien, Tadahiko

AU - Taira, Naruto

AU - Doihara, Hiroyoshi

PY - 2018/6/11

Y1 - 2018/6/11

N2 - 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.

AB - 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.

KW - Breast cancer

KW - Dose-dense chemotherapy

KW - Feasibility

KW - Japanese

KW - Neoadjuvant

UR - http://www.scopus.com/inward/record.url?scp=85048357176&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85048357176&partnerID=8YFLogxK

U2 - 10.1007/s12282-018-0877-1

DO - 10.1007/s12282-018-0877-1

M3 - Article

SP - 1

EP - 6

JO - Breast Cancer

JF - Breast Cancer

SN - 1340-6868

ER -