Feasibility study of FEC-chemotherapy with dose-intensive epirubicin as initial treatment in high-risk breast cancer

E. Van Der Wall, D. J. Richel, Y. H. Kusumanto, E. J.T. Rutgers, J. H. Schornagel, C. C.E. Schaake-koning, J. L. Peterse, S. Rodenhuis

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Background: The prognosis of patients with stage III B breast carcinoma with metastasis to the apical axillary lymph nodes is poor despite adequate local control achieved by surgery and/or radiation therapy. This study evaluated the feasibility of a dose-intensive up-front chemotherapy regimen in this subgroup of patients. Patients and methods: A preoperative chemotherapy regimen consisting of 3 courses of fluorouracil 500 mg/m2, dose-intensive epidoxorubicin 120 mg/m2 and cyclophosphamide 500 mg/m2 (DIE-FEC), was administered at 21-day intervals without hematopoietic growth factors to 31 patients with apex-positive disease. All patients were below 60 years of age and none had had prior chemotherapy or radiotherapy. Results: Seven patients achieved clinical complete responses (23%), and 21 achieved clinical partial responses (68%); three patients had stable disease (10%), one of whom had only ductal carcinoma in situ at histopathologic evaluation, which suggested an additional response to therapy. The major toxicity was moderate bone marrow suppression with a median WBC nadir of 1650/u.l (range 500-4600). Other toxic effects were mild. Conclusion: DIE-FEC is well-tolerated and highly effective as up-front chemotherapy in relatively young patients with high-risk breast cancer, with a 90% (CI 74%-98%) clinical objective response rate.

Original languageEnglish (US)
Pages (from-to)791-792
Number of pages2
JournalAnnals of Oncology
Issue number9
StatePublished - Nov 1993
Externally publishedYes


  • Breast cancer
  • Epirubicin
  • Pre-operative chemotherapy

ASJC Scopus subject areas

  • Hematology
  • Oncology


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