Back to Search
Start Over
[Indications, contra-indications, expected results and choice of neoadjuvant chemotherapy for operable breast cancer].
- Source :
-
Bulletin du cancer [Bull Cancer] 2006 Nov; Vol. 93 (11), pp. 1121-9. - Publication Year :
- 2006
-
Abstract
- Neoadjuvant chemotherapy in breast cancer corresponds to the use of a systemic treatment applied before loco-regional treatment (surgery and/or radiotherapy). Initiated in the seventies for treatment of the locally advanced and/or inflammatory breast cancers, induction chemotherapy has been extended in the beginning of eighties for cancers known as operable (size higher than 3 cm and/or in central position) in order to allow a more frequent conservating surgery. This objective is obtained in 75% of the cases approximately without increase in the risk of local relapse and without noxious effect on overall survival, in spite of the delay of the loco-regional treatment. Neo-adjuvant chemotherapy progressively moved with the advent of major drugs in breast cancer which are anthracyclins, vinorelbine and taxans. But to date, no protocol was essential like an uncontested standard. However, it seems that obtaining a complete clinical response is the best guarantor to avoid relapse. That seems to be observed only after 6 cycles, even 8 cycles of chemotherapy, each cycle combining the 2 major drugs for the treatment of breast cancer of which are anthracyclins and taxanes employed according a sequential scheme after a based-anthracyclins treatment, except any cardiac contra-indication. Moreover, the use of targeted therapeuticals like Herceptin, with a chemotherapy, seems to be promising and should be more studied. Finally, when a neoadjuvant chemotherapy is administered, the evaluation of the pre-treatment biopsy helps to establish key patient-management parameters such as tumour type, SBR grade and immunohistochemical parameters. This evaluation provides predictive parameters with regards to drug response (hormonal status, overexpression of Her2). The further studies realised in this way will permit to improve the results yet obtained.
- Subjects :
- Age Factors
Antibodies, Monoclonal administration & dosage
Antibodies, Monoclonal, Humanized
Breast Neoplasms pathology
Breast Neoplasms surgery
Chemotherapy, Adjuvant methods
Contraindications
Docetaxel
Female
Humans
Paclitaxel administration & dosage
Taxoids administration & dosage
Trastuzumab
Treatment Outcome
Vinblastine administration & dosage
Vinblastine analogs & derivatives
Vinorelbine
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Breast Neoplasms drug therapy
Neoadjuvant Therapy methods
Subjects
Details
- Language :
- French
- ISSN :
- 1769-6917
- Volume :
- 93
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Bulletin du cancer
- Publication Type :
- Academic Journal
- Accession number :
- 17145582