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Vinorelbine, Epirubicin, and Methotrexate (VEM) as Primary Treatment in Locally Advanced Breast Cancer

^a Thomayer Memorial Teaching Hospital, Praha, Czech Republic; ^b University Hospital L. Pasteura, Kosice, Slovak Republic; ^c Fakultni Thomayerova nemocnice, Praha, Czech Republic; ^d F.D. Roosewelta, Banska Bystrica, Slovak Republic; ^e Zilina, Slovak Republic; ^f Jicin, Czech Republic; ^g Pardubice, Czech Republic; ^h Masaryk Instititute of Oncology, Brno, Czech Republic; ⁱ University Hospital, Plzen, Czech Republic; ^j Nemonice Poliklinikou, Kladno, Czech Republic; ^k University Hospital Motol, Praha, Czech Republic; ^l Nitra, Slovak Republic; ^m Centre Jean Perrin, Clermont-Ferrand, France

Correspondence: J. Abrahamova, M.D., Oncology Department, Tchomayer Teaching Hospital, Videnska 800, 14629 Praha 4, Czech Republic. Telephone: 00-420-2-47-21-457; Fax: 00-420-2-47-21-457; e-mail: jitka.abrahamova{at}ftn.cz

Purpose. This phase II trial of VEM (vinorelbine + epirubicine + methotrexate) in the treatment of locally advanced breast cancer was conducted to obtain downstaging to allow surgery and breast conservation.

Patients and Methods. This multicenter study recruited 58 patients with locally advanced breast cancer (two patients ineligible); 56 were evaluable for response and tolerance.

Results. Downstaging was obtained in 77% of the patients with a pathological complete response (pCR) rate of 9%. At 33 months of follow-up, median survival has not been reached. Neutropenia grade 3-4 was reported in 31% of cycles with 3% of cycles with infection grade 3. Alopecia grade 3 was noticed for 71% of patients.

Conclusion. VEM represents an effective regimen for patients with locally advanced breast cancer, allowing an important pCR. Moreover, this regimen appears to be particularly well tolerated.

Key Words. Locally advanced breast cancer • Pathological complete response • Conservative surgery • Downstaging

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