Abstract
PURPOSE: Several preclinical studies showed that short-term pretreatment of breast cancer cells with estrogens can increase the antitumor efficacy of different cytotoxic drugs. Some early clinical studies in patients with advanced breast cancer did seem to support these findings. Therefore, the efficacy of estrogenic recruitment followed by chemotherapy was compared with that of chemotherapy alone in a randomized phase III study in women with lymph node–positive primary breast cancer. PATIENTS AND METHODS: Three hundred twenty-eight patients with stage II/IIIA breast cancer who were younger than 66 years of age were randomly allocated to chemotherapy with fluorouracil, doxorubicin, and cyclophosphamide (FAC) or FAC plus pretreatment with ethinyl estradiol (EE2). FAC (500, 50, and 500 mg/m2, respectively) was administered intravenously once every 4 weeks for four cycles. EE2 (0.5 mg) was administered orally, both 24 hours and immediately preceding FAC chemotherapy. RESULTS: Patient and tumor characteristics and chemotherapy dosages were comparable in both treatment groups. Of 318 assessable patients, with a median follow-up of 6.8 years, 177 patients had a relapse and 127 died. No significant differences were observed between the two treatment groups with respect to relapse-free, local recurrence–free, and overall survival according to univariate and multivariate analyses adjusted for age, menopausal status, tumor size, grade, number of positive nodes, and steroid-receptor status. The power for the detection of an increase of 50% in the median relapse-free survival was 80%. CONCLUSION: Estrogenic recruitment of breast cancer cells before FAC chemotherapy did not influence the efficacy of adjuvant chemotherapy in stage II/IIIA breast cancer patients after a follow-up of 6.8 years.
Publisher
American Society of Clinical Oncology (ASCO)
Reference43 articles.
1. Tamoxifen for early breast cancer: an overview of the randomised trials
2. Polychemotherapy for early breast cancer: an overview of the randomised trials
3. Osborne CK, Boldt DH, Estrada P: Human breast cancer cell cycle synchronization by estrogens and antiestrogens in culture. Cancer Res 44:1433,1984-1439,
4. Weichselbaum RR, Hellman S, Piro AJ, et al: Proliferation kinetics of a human breast cancer line in vitro following treatment with 17 beta-estradiol and 1-beta-D-arabinofuranosylcytosine. Cancer Res 38:2339,1978-2342,
5. Effect of hormonal manipulation and doxorubicin administration on cell cycle kinetics of human breast cancer cells
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