Aim: To evaluate the relative activity of the
sequential administration of doxorubicin and cyclophosphamide
(AC) followed by docetaxel alone, as primary systemic therapy in
patients with breast cancer, using an in vivo chemosensitivity
predictive assay. Patients and Methods: Patients with stage IIIII
breast cancer received two cycles of AC (60/600 mg/m2 every
3 weeks) followed by two cycles of docetaxel (100 mg/m2 every 3
weeks). All patients underwent comprehensive breast imaging
prior to chemotherapy, after two AC and after docetaxel. Results:
Forty-two patients were accrued and evaluated by intention-totreat
analysis. After two cycles of AC, the median tumor
shrinkage was 18.3%, whereas treatment with docetaxel
provided an additional median tumor shrinkage of 34.2%.
Pathological complete remission was observed in 5 patients
(11.9%), whereas 26 patients (61.9%) experienced a partial
response. Conclusion: The relative contribution of docetaxel to
tumor mass reduction seemed to be greater than that of AC.
However, the slow rate of tumor shrinkage observed may
indicate that the activity of the first 2 cycles of AC is carried over
into the part of treatment with docetaxel.
