A Direct Synergistic Effect of Immunotherapy and Chemotherapy as a New Paradigm in Treatment of Breast Cancer
Annual rept. 1 Apr 2008-31 Mar 2009
H LEE MOFFITT CANCER CENTER AND RESEARCH INST TAMPA FL
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Treatment of locally advanced or metastatic breast cancer remains a very difficult clinical problem. Chemotherapy is the treatment of choice for most of those patients. It is given as an adjuvant or neo-adjuvant settings alone or in combination with hormone therapy or Herceptin. Two classes of the drugs are primarily used anthracyclines doxorubicin, epirubicin, mitoxantrone and taxanes paclitaxel, docetaxel. In addition to the well-described toxicity the efficacy of the treatment remains relatively low. Median survival for patients with metastatic breast cancer is 18-24 months. Among patients treated with systemic chemotherapy 16.6 achieved complete responses and only 3.1 remained in complete remission for more than 5 years 1. Patients with locally advanced breast cancer LABC have a poor prognosis when treated with surgery and radiotherapy. Preoperative neo-adjuvant chemotherapy has been developed as an alternative therapeutic strategy as it allows surgical intervention in patients who present with bulky primary disease. In general, neoadjuvant chemotherapy results in a complete-response rate of 10 to 35.
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