| Objective: Neoadjuvant Chemotherapy(NAC)with doxorubicin is now the standard treatment for primary breast cancer.Although anthracyclines have a prominent effect on breast cancer,with the increasing dosage,the toxic side effects of doxorubicin such as bone marrow suppression,alopecia,gastrointestinal reactions,especially cardiotoxicity.Pegylated liposomal doxorubicin(PEG-LG)has been demonstrated to achieve equivalent efficacy to conventional doxorubicin with significantly less toxic side effects including cardiotoxicity.Methods: Our trial conducts a NAC regimen that was based on four cycles of PEG-LD 40 mg/m2 plus cyclophosphamide(CPM)600 mg/m2 on day 1 every 3 weeks followed by four cycles of docetaxel(DTX)85 mg/m2 on day 1 every 3 weeks.Mammography,breast-ultrasound(US),and enhancement computed tomography(CT)or magnetic resonance imaging(MRI)were performed at baseline to determine the longest diameter of the primary breast tumor.Baseline assessments also included brain CT scan and bone scan for all patients.laboratory evaluation(routine blood test,biochemistries,urinalysis,and tumor markers),an echocardiography,and an electrocardiogram.and other toxicity assessments were performed every 3 weeks during treatment and before surgery.Primary end point was the pathological complete response(pCR)rate in the breast.Treatment toxicities and safety were assessed.Results: The results showed that the breast pCR rate was 19.64%(95% CI 12.3%-27.0%),and the axillary lymph node negative conversion rate after NAC was 33.3%(95 % CI 22.5-44.2%).Among the different molecular type of patients,the triple-negative had a much higher pCR which was 43.75%;the pCR rate of Luminal A subtype is 0%.No significant decrease in left ventricular ejection fraction was seen.Conclusion: Our data indicates that this regiment can be another option for the neoadjuvant treatment of patients with LABC,especially the triple-negative subtype and the patients with heart abnormality. |
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