Department of Breast Surgery, Cancer Hospital, Fudan University, Shanghai, China.
Ann Oncol. 2010 May;21(5):961-7. doi: 10.1093/annonc/mdq041. Epub 2010 Mar 8.
To evaluate the activity and safety of nonanthracycline-containing weekly PCb [paclitaxel (Taxol) plus carboplatin] regimen in neoadjuvant treatment of breast cancer.
Eligible patients were assigned to receive four cycles of PCb with dose of paclitaxel 80 mg/m(2) and carboplatin at an area under the curve of 2 mg x min/ml, given day 1, day 8 and day 15 of every 4 weeks. Pathological complete remission (pCR) was defined as no invasive cancer in breast and axillary samples.
Overall, 107 consecutive patients received weekly PCb treatment from December 2007 to December 2008, and one was diagnosed with bilateral breast cancer. A total of 85.2% of patients were initially diagnosed with stage III diseases. Clinical response rate was 86.1% with complete remission rate 32.4%. Twenty-one patients achieved pCR after neoadjuvant treatment, with pCR rate 19.4%. The incidence of grade 3-4 neutropenia was 40.2% and only one patient was reported with febrile neutropenia. Severe anemia and thrombocytopenia occurred in 4.7% and 0.9%, respectively, of patients. Peripheral neuropathy was frequent but never severe. Patients with estrogen receptor-negative, progesterone receptor-negative, triple-negative or human epidermal growth factor receptor 2 (Her2)-positive subtype disease had higher pCR.
Weekly PCb regimen was very active and tolerable as neoadjuvant treatment of breast cancer. This weekly PCb regimen should consider as a reasonable nonanthracycline-containing option in the neoadjuvant treatment of breast cancer.
评估新辅助治疗乳腺癌中不含蒽环类药物的每周 PCb[紫杉醇（Taxol）加卡铂]方案的活性和安全性。
合格的患者被分配接受四个周期的 PCb 治疗，剂量为紫杉醇 80mg/m²，卡铂曲线下面积为 2mg×min/ml，每 4 周的第 1、第 8 和第 15 天给药。病理完全缓解（pCR）定义为乳腺和腋窝样本中无浸润性癌。
总体而言，2007 年 12 月至 2008 年 12 月期间，连续 107 例患者接受了每周 PCb 治疗，其中 1 例被诊断为双侧乳腺癌。患者最初诊断为 III 期疾病的比例为 85.2%。临床缓解率为 86.1%，完全缓解率为 32.4%。21 例患者在新辅助治疗后达到 pCR，pCR 率为 19.4%。3-4 级中性粒细胞减少症的发生率为 40.2%，仅 1 例患者发生发热性中性粒细胞减少症。严重贫血和血小板减少症的发生率分别为 4.7%和 0.9%。周围神经病变较为常见，但从未严重。雌激素受体阴性、孕激素受体阴性、三阴性或人表皮生长因子受体 2（Her2）阳性亚型疾病患者的 pCR 更高。
每周 PCb 方案作为乳腺癌新辅助治疗非常有效且耐受良好。这种每周 PCb 方案应被视为新辅助治疗乳腺癌中合理的不含蒽环类药物选择之一。
