Research Of Efficacy And The Influence Factors In Two Neoadjuvant Chemotherapy Regiments In Patients With Breast Cancer

Background and aims:Currently breast cancer remains one of the most common cancers in women, and which is the second common risk for cancer-related death worldwide. Neoadjuvant chemotherapy is currently the standard of care for the management of locally advanced invasive breast cancer, because of its safety and efficacy, it has been more widely appreciated and applied in systemic treatment of breast cancer. The focus of cancer treatment lies in tailoring regimens to patients by identifying efficacy response to therapy and developing novel agents. Because a significant proportion of breast tumors are resistant to chemotherapeutic agents, the standard regimens or protocols for neoadjuvant chemotherapy in breast cancer patients has not been uniform. This study is to to explore the use of different chemotherapy regimens (FEC VS. TEC) in patients with breast cancer, to identify the pathologic response and clinical efficacy in these patients, and to evaluate the possible factors impact on the efficacy.Methods:159 patients with primary breast tumor were identified and two regimens including TEC and EFC were investigated. The pathologic response and clinical efficacy in these patients was been assessed, and the possible factors relation with the efficacy was been evaluated.Results:A complete pathological response (pCR) was observed in in 5 of 73 (6.8%) patients, pCR and pathologic response (PR) were present in 46 of 73 (63%) patients with the regimens of TEC. A complete pathological response (pCR) was observed in in 3 of 86 (3.5%) patients, pCR and pathologic response (PR) were present in 46 of 86 (53.5%) patients with the regimens of FEC. Although there was no significant correlation was found between two groups in clinical response, pathological response, the rate of breast-conserving surgery and overall survival, compared with the FEC groups TEC group cancer could receive the pathologic response at less cycles of treatment. In multivariate analysis, the positive expression of ER was significant independent prognostic factors for pathologic response(p<0.001), while Her-2 was only correlated with the pathologic response in TEC group (p<0.001).The tumors were subdivided into luminal-A, luminal-B, ERBB2+, and basal-like subtypes by Immunohistochemistry. There were significant differently pathologic respond according to molecular phenotypes,the luminal-A subtype had the worst pathologic respond but had longest overall survival.Conclusions:No significant difference pathologic respond was been found between FEC regiment and TEC regiment, but TEC regimen could receive the pathologic response at less cycles of treatment. The expression levels of hormone receptors were predictive for pathologic respond, while Her-2 is only predictive for TEC regimen. The luminal-A subtype had the worst pathologic respond but had longest overall survival.