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Viens et al. 287
Table 5. Pathologic response rate with conventional chemotherapy
Reference Patients (n) Chemotherapy Microscopic complete response rate
Feldman 10
Israel 23
90 5FU-D-Cy 7%
24 5FU-Cy 0%
Maloisel 12 44 D-5FU-Cy 18%
Armstrong 13 24 D-Cy-VC-MTX-L-5FU 17%
Chevallier 15
Colozza 24
97 5FU-Ep-Cy ± lenograstim 22%
31 CDDP-D-Cy 8%
of chemotherapy, i.e., 15 g/m 2
of cyclophosphamide, 300 mg/m 2
of doxorubicin,
and 5000 mg/m 2
of 5FU, in 9 weeks. This strategy of high-dose sequential
chemotherapy with stem cell support allows the administration of a total dose of
cyclophosphamide to be given that is approximately 7.5 times higher than given in
1 0
four cycles of standard FAC (5-fluorouracil, adriamycin, cyclophosphamide) and
three times higher than in the 5-fluorouracil, epirubicin, cyclophosphamide (FEC)
high-dose regimen described by Chevallier et al. 15
Our data show that such an
increase in dose and dose intensity is achieved in 92% of patients with nonmetastatic
inflammatory breast cancer with the use of rG-CSF on an outpatient schedule.
The second end point of our study was to evaluate the response rate of
inflammatory breast cancer to a dose-intensified cyclophosphamide/doxorubicin/5FU
regimen. The clinical response rate was high (overall
response rate 90%), as generally described with other anthracycline-based
regimens. When the pathologic response in the breast was considered in 87
évaluable patients, only 32% had total disappearance of invasive tumor cells.
Pathologic response rates, comparably defined, have been previously published
after conventional or moderately intensified systemic induction chemotherapy
(Table 5). Feldman et al., 10
using standard FAC, reported a 12% pathologic
complete response rate in 90 patients. Chevallier et al., 15
using an intensified
FEC, reported a 22% pathologic complete response rate in 97 patients. In other
studies with smaller numbers of patients (