Feasibility and safety of weekly sequential epirubicin-paclitaxel as adjuvant treatment for operable breast cancer patients older than 70 years

Clin Breast Cancer. 2011 Aug;11(4):235-40. doi: 10.1016/j.clbc.2011.06.002. Epub 2011 Jul 7.

Abstract

Background: There are currently no internationally agreed recommendations for the management of adjuvant chemotherapy in women aged >70 years with high-risk breast cancer. The purpose of this study was to assess the feasibility and the tolerance of adjuvant weekly sequential epirubicin-paclitaxel combination in this setting.

Patients and methods: From 2005 to 2009, 59 women over 70 years of age with operable breast cancer and who required adjuvant chemotherapy were proposed weekly sequential epirubicin-paclitaxel chemotherapy schedule, and were prospectively registered. Compliance and treatment tolerance were studied. We also report preliminary results of disease-free survival (DFS) and overall survival (OS).

Results: Weekly sequential epirubicin-paclitaxel was well tolerated. No grade 4 adverse event occurred. No secondary malignancy was observed. Compliance with chemotherapy was good: 95% of patients received the six planned cycles. After a median follow-up of 24 months, median DFS and OS were not reached, there were only three relapses, and two cancer-related deaths were reported.

Conclusion: This study conducted in patients over 70 years of age demonstrates the feasibility of weekly adjuvant chemotherapy including anthracyclines and taxanes in a sequential schedule. This regimen is safe in terms of hematologic, nonhematologic, and cardiac toxicities, and showed encouraging efficacy, justifying further studies in geriatric patients.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology
  • Chemotherapy, Adjuvant
  • Epirubicin / administration & dosage
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Immunoenzyme Techniques
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Paclitaxel / administration & dosage
  • Prospective Studies
  • Receptor, ErbB-2 / metabolism
  • Receptors, Estrogen / metabolism
  • Receptors, Progesterone / metabolism
  • Survival Rate
  • Treatment Outcome

Substances

  • Receptors, Estrogen
  • Receptors, Progesterone
  • Epirubicin
  • Receptor, ErbB-2
  • Paclitaxel