Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep;11(3):327-341.
doi: 10.1007/s40487-023-00233-8. Epub 2023 Jun 8.

Neoadjuvant Doxorubicin-Paclitaxel Combined Chemotherapy in Patients with Inoperable Stage III Breast Cancer: A Retrospective Cohort Study with 10 Years of Follow-Up in Vietnam

Duc Thanh Le  1 , Lap Thanh Bui  1 , Chu Van Nguyen  2   3 , Kien Hung Do  4 , Giang Le Tran  5 , Tu Anh Do  6
Affiliations

Neoadjuvant Doxorubicin-Paclitaxel Combined Chemotherapy in Patients with Inoperable Stage III Breast Cancer: A Retrospective Cohort Study with 10 Years of Follow-Up in Vietnam

Duc Thanh Le et al. Oncol Ther. 2023 Sep.

Abstract

Introduction: The combination of doxorubicin and paclitaxel (AP) is widely used in our country for the neoadjuvant treatment of breast cancer as well as metastatic breast cancer. The AP regimen has shown promise as a neoadjuvant therapy for breast cancer that improves pathological complete response (pCR), increases the rate of conservative surgery, and improves the survival of patients. However, up to now, no research has evaluated the response of this regimen for the neoadjuvant treatment of advanced breast cancer, especially with a 10-year period of follow-up.

Methods: This retrospective analysis reviewed 126 patients with inoperable stage III breast cancer who received neoadjuvant chemotherapy with doxorubicin 50 mg/m2 plus paclitaxel 175 mg/m2 every 3 weeks for a maximum of six courses followed by surgery. pCR was evaluated. Survival was analyzed for all breast cancer patients using Kaplan-Meier and log-rank models.

Results: Of 126 women treated with neoadjuvant chemotherapy (NAC), the overall pCR rate was 25.4% and was significantly higher in patients with tumor stage cT1-T2, hormone receptor-negative (HR-negative), and human epidermal growth factor receptor 2 (HER2)-positive disease. Patients achieving pCR had significantly longer disease-free survival (DFS) and overall survival (OS). Ten-year DFS rates were 43.8% vs. 25.0% (p = 0.030) and 10-year OS rates were 59.4% vs. 28.9% (p = 0.003) for patients with pCR and non-pCR, respectively. The cumulative 10-year DFS was 19.6% for patients with HR-negative disease and 37.3% for those with HR-positive disease. Achieving pCR was associated with improved 10-year OS and DFS. Several clinicopathological features were closely associated with pCR in the inoperable stage III breast cancer patients who were treated by neoadjuvant chemotherapy.

Conclusion: Achieving pCR was associated with improved 10-year OS and DFS. Patients with advanced breast cancer with HR-negative and HER2-positive status who benefited from the AP neoadjuvant therapy regimen were significantly more likely to achieve pCR.

Keywords: Advanced breast cancer; Doxorubicin-paclitaxel regimen; Neoadjuvant chemotherapy; Pathological complete response.

PubMed Disclaimer

Conflict of interest statement

Duc Thanh Le, Lap Thanh Bui, Kien Hung Do, Tu Anh Do, Giang Le Tran and Chu Van Nguyen declare that they have no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1
Survival curves for all patients with inoperable invasive BC. A Disease-free survival. B Overall survival. BC breast cancer
Fig. 2
Fig. 2
DFS and OS according to HR status in patients with inoperable invasive BC. A Disease-free survival. B Overall survival. DFS disease-free survival, OS overall survival, HR hormone receptor, BC breast cancer
Fig. 3
Fig. 3
DFS and OS according to HER2 status in patients with inoperable invasive BC. A Disease-free survival. B Overall survival. DFS disease-free survival, OS overall survival, HER2 human epidermal growth factor receptor 2, BC breast cancer
Fig. 4
Fig. 4
DFS and OS according to pCR status in patients with inoperable invasive BC. A Disease-free survival. B Overall survival. DFS disease-free survival, OS overall survival, pCR pathological complete response, BC breast cancer
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Mai DTT, Junda T, Sumdaengrit B. Symptom experiences and quality of life of Vietnamese patients with advanced cancer. J Health Sci Res. 2020;14(3):145–156.
    1. Le TD, Carney PA, Lee-Lin F, Mori M, Chen Z, Leung H, et al. Differences in knowledge, attitudes, beliefs, and perceived risks regarding colorectal cancer screening among Chinese, Korean, and Vietnamese sub-groups. J Community Health. 2014;39(2):248–265. doi: 10.1007/s10900-013-9776-8. - DOI - PMC - PubMed
    1. Anelli A, Brentani R, Gadelha A, Albuquerque AAD, Soares F. Correlation of p53 status with outcome of neoadjuvant chemotherapy using paclitaxel and doxorubicin in stage IIIB breast cancer. Ann Oncol Off J Eur Soc Med Oncol. 2003;14(3):428–432. doi: 10.1093/annonc/mdg104. - DOI - PubMed
    1. Gogia A, Raina V, Deo S, Shukla N, Mohanti B, Sharma D. Taxane and anthracycline based neoadjuvant chemotherapy for locally advanced breast cancer: institutional experience. Asian Pac J Cancer Prev. 2014;15(5):1989–1992. doi: 10.7314/apjcp.2014.15.5.1989. - DOI - PubMed
    1. Read R, Flitcroft K, Snook K, Boyle F, Spillane A. Utility of neoadjuvant chemotherapy in the treatment of operable breast cancer. ANZ J Surg. 2015;85(5):315–320. doi: 10.1111/ans.12975. - DOI - PubMed