Assesssment of the effect of pretreatment with neoadjuvant therapy on primary breast cancer

Br J Cancer. 1996 Mar;73(6):758-62. doi: 10.1038/bjc.1996.132.

Abstract

Patients with invasive cancer of the breast (T1-4, N0-2, M0) were assigned to pretreatment based on oestrogen receptor (ER) status; patients with ER-negative tumours received chemotherapy [mitozantrone, methotrexate and mitomycin C (MMM)] for 3 months, patients with ER-positive tumours underwent endocrine therapy [luteinising hormone releasing hormone (LHRH) agonist goserelin (leuprolide-premenopausal) or 4-hydroxyandrostenedione (formestane-post-menopausal)] for 3 months. Of the first 100 patients assessed at 3 months, 47 with ER-positive tumours had a 40.4% response (premenopausal 53.8%; post-menopausal 35%) and 53 with ER-negative tumours had a 60% response (premenopausal 57%; post-menopausal 63%). Patients with early breast cancer (T1/T2) had a complete clinical resolution in 41% (16/39) of cases after MMM and in 20% (7/35) of cases following endocrine therapy compared with 14% (2/14) advanced tumours (T3/T4) following MMM and (0/12) following endocrine therapy. However, in those patients achieving a complete clinical response, subsequent appropriate surgery showed that 16 of 19 patients (84%) had evidence of residual viable tumour on histological examination.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Androstenedione / analogs & derivatives*
  • Androstenedione / therapeutic use
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Breast Neoplasms / chemistry
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / surgery*
  • Chemotherapy, Adjuvant
  • Combined Modality Therapy
  • Female
  • Goserelin / therapeutic use*
  • Humans
  • Immunohistochemistry
  • Methotrexate / administration & dosage
  • Methotrexate / adverse effects
  • Middle Aged
  • Mitomycin / administration & dosage
  • Mitomycin / adverse effects
  • Mitoxantrone / administration & dosage
  • Mitoxantrone / adverse effects
  • Neoplasms, Hormone-Dependent / chemistry
  • Neoplasms, Hormone-Dependent / drug therapy*
  • Neoplasms, Hormone-Dependent / surgery*
  • Receptors, Estrogen / analysis

Substances

  • Antineoplastic Agents
  • Antineoplastic Agents, Hormonal
  • Receptors, Estrogen
  • Goserelin
  • Androstenedione
  • Mitomycin
  • Mitoxantrone
  • formestane
  • Methotrexate

Supplementary concepts

  • MMM protocol 2