MD Anderson results w different concurrent chemo w herceptin combos reviewed

[Lani]

Cancer. 2011 Sep 27. doi: 10.1002/cncr.26555. [Epub ahead of print]
Efficacy of neoadjuvant therapy with trastuzumab concurrent with anthracycline- and nonanthracycline-based regimens for HER2-positive breast cancer.
Bayraktar S, Gonzalez-Angulo AM, Lei X, Buzdar AU, Valero V, Melhem-Bertrandt A, Kuerer HM, Hortobagyi GN, Sahin AA, Meric-Bernstam F.
Source
Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Abstract
BACKGROUND:
The aim of this study was to evaluate the pathologic complete response (pCR) rates and relapse-free survival (RFS) and overall survival (OS) of patients receiving neoadjuvant systemic therapy (NST) with trastuzumab in combination with an anthracycline- or nonanthracycline-based regimen.

METHODS:
In this retrospective nonrandomized study, the authors reviewed records of 300 patients with HER2-positive breast cancer treated with either sequential paclitaxel and trastuzumab and FEC75 in combination with trastuzumab (PH-FECH) or docetaxel, carboplatin, and trastuzumab (TCH). The Kaplan-Meier product-limit method was used to estimate RFS and OS rates. Logistic regression models and Cox proportional hazards models were fit to determine the associations between NST, pCR, and survival.

RESULTS:
There was no significant difference in the decline in cardiac ejection fraction; however, patients who received PH-FECH had fewer cardiac comorbidities at baseline (P = .002). pCR rates were 60.6% and 43.3% for patients who received PH-FECH (n = 235) and TCH (n = 65), respectively (P = .016). Patients who received PH-FECH were 1.45 times more likely to have a pCR (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.06-1.98; P = .02). Three-year RFS rates were 93% and 71% (P < .001), and 3-year OS rates were 96% and 86% (P = .008) for patients who received PH-FECH and TCH, respectively. Patients who received PH-FECH had a lower risk of recurrence (hazard ratio [HR], 0.27; 95% CI, 0.12-0.60; P = .001) and death (HR, 0.37; 95% CI, 0.12-1.13; P = .08) than those treated with TCH.

CONCLUSIONS:
The type of NST in HER2-positive breast cancer is predictive of pCR rate independent of disease and patient characteristics. Although TCH is active, PH-FECH shows a higher pCR rate and RFS advantage. Cancer 2011. © 2011 American Cancer Society.

Copyright © 2011 American Cancer Society.

PMID: 21953213

[hutchibk]

So, FECH is: 5FU, Ellence, Cytoxan and Herceptin? And does 'neo-adjuvant' replace primary chemo treatment?

I wonder if it is also effective for mets patients who have already had TCH as their second line of treatment when they initially recurred?

[Lani]

from NCI:



Cancer Drug Information
Posted: 07/08/2011 Updated: 08/08/2011


FEC
This page contains brief information about the drug combination called FEC. The drugs in the combination are listed, and links to individual drug summaries are included.


Drugs in the FEC combination:

F = Fluorouracil
E = Epirubicin Hydrochloride
C = Cyclophosphamide

Chemotherapy is often given as a combination of drugs. Combinations usually work better than single drugs because different drugs kill cancer cells in different ways.

Each of the drugs in this combination is approved by the Food and Drug Administration (FDA) to treat cancer or conditions related to cancer.

Use in Cancer
FEC is used to treat:

Breast cancer.
FEC is also known as CEF.

[kiwigirl]

Fec was my first line of treatment with herceptin and docetaxol. I had three FEC and three herceptin and taxane.
This does not cross blood brain. I had mets less than a year later after finishing FEC. It probably has a better effect if you are stage 1 or 2 maybe?