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The Oncologist, Vol. 7, No. 5, 418–423, October 2002
© 2002 AlphaMed Press

Efficacy of a Primary Chemotherapy Regimen Combining Vinorelbine, Epirubicin, and Methotrexate (VEM) as Neoadjuvant Treatment in 89 Patients with Operable Breast Cancer

Isabelle Van Praagha, Hervé Curea, Bernard Leducb, Sabine Charriera, Guillaume Le Bouedeca, Jean-Louis Acharda, Jean-Pierre Ferrierea, Viviane Feillela, Monique de Latoura, Jacques Dauplata, Philippe Cholleta

a Centre Jean Perrin and INSERM U 71, Clermont-Ferrand, France; b Centre Hospitalier Général, Brive La Gaillarde, France

Correspondence: Philippe Chollet, M.D., Centre Jean Perrin and INSERM U 71, 58 Rue Montalembert, B.P. 392, 63011 Clermont-Ferrand Cedex 1, France. Telephone: 04-73-278198; Fax: 04-73-278029; e-mail: Philippe.Chollet{at}cjp.u-clermont1.fr

Purpose. In order to improve the breast conservation rate for noninflammatory operable breast cancer stage II and IIIa, neoadjuvant chemotherapy containing vinorelbine, 25 mg/m2, epirubicin, 35 mg/m2, and methotrexate, 20 mg/m2, VEM, was administered days 1 and 8 every 28 days for six cycles.

Methods. From October, 1991 to April, 1996, 89 patients (median age 52 years, range 31-72; 68 stage II and 19 stage IIIa) received 519 cycles (median six) of VEM chemotherapy.

Results. Hematotoxicity was mild (World Health Organization grade 3-4 neutropenia in 28% of cycles for 22 patients, and anemia or thrombocytopenia >grade 2) when it occurred, and there were no toxic deaths. The clinical objective response was 90% (28% complete response and 62% partial response). All patients underwent surgery: 77 (87%) had conservative and 12 (13%) had modified radical mastectomy, and 12 (14%) reached pathological complete response. At December, 2000, with a median follow-up of 86 months (39-100), 13 patients had relapsed, and five had died of metastatic disease. Median disease-free survival was 100 months (8.4 years) and median survival had not yet been reached.

Key Words. Breast cancer • Neoadjuvant therapy • Vinorelbine • Epirubicin • Methotrexate




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