Metaplastic breast cancer: Experience with ifosfamide based chemotherapy.

Adriamycin Breast cancer Chemotherapy Ifosfamide Metaplastic

Journal

Current problems in cancer
ISSN: 1535-6345
Titre abrégé: Curr Probl Cancer
Pays: United States
ID NLM: 7702986

Informations de publication

Date de publication:
21 Sep 2024
Historique:
received: 20 02 2024
revised: 26 08 2024
accepted: 10 09 2024
medline: 23 9 2024
pubmed: 23 9 2024
entrez: 22 9 2024
Statut: aheadofprint

Résumé

Metaplastic breast cancer (MPBC) is a rare variant of breast cancer and most treatment protocols are based on the guidelines for triple negative breast cancer. However, response to standard anthracycline and taxane based chemotherapy is poor. Published literature on use of ifosfamide based chemotherapy in the first line setting for MPBC is scarce. We carried out this record based analysis on MPBC patients treated at our institute with the combination of ifosfamide and Adriamycin (IA) as first line therapy. Patients were analysed for the clinical and demographic profile; pathology and treatment details; and treatment outcomes. Four patients who received IA chemotherapy were evaluated. Three of the four patients were postmenopausal. The median size of the tumor was 7.5 cm, only one patient had a heavy nodal burden and lung was the most common site of metastases seen in all three patients with metastatic disease. Pathology showed heterogenous, mixed histology with high grade tumors. All patients had triple negative tumors. All four patients underwent mastectomy and received IA chemotherapy as per standard doses. One patient had complete response, one had partial response and one patient progressed after 4 cycles of chemotherapy. The patient with localized disease continues to be disease free till date. Grade 3,4 neutropenia and grade 2 anemia was the most common chemotherapy related toxicity. The response rates in MPBC with IA regimen appear to be similar to the currently used anthracycline-taxane combinations, with slightly more haematological toxicity. Ifosfamide and adriamycin regimen may be considered in MPBC patients as primary or salvage systemic therapy.

Sections du résumé

BACKGROUND BACKGROUND
Metaplastic breast cancer (MPBC) is a rare variant of breast cancer and most treatment protocols are based on the guidelines for triple negative breast cancer. However, response to standard anthracycline and taxane based chemotherapy is poor. Published literature on use of ifosfamide based chemotherapy in the first line setting for MPBC is scarce.
PATIENTS AND METHODS METHODS
We carried out this record based analysis on MPBC patients treated at our institute with the combination of ifosfamide and Adriamycin (IA) as first line therapy. Patients were analysed for the clinical and demographic profile; pathology and treatment details; and treatment outcomes.
RESULTS RESULTS
Four patients who received IA chemotherapy were evaluated. Three of the four patients were postmenopausal. The median size of the tumor was 7.5 cm, only one patient had a heavy nodal burden and lung was the most common site of metastases seen in all three patients with metastatic disease. Pathology showed heterogenous, mixed histology with high grade tumors. All patients had triple negative tumors. All four patients underwent mastectomy and received IA chemotherapy as per standard doses. One patient had complete response, one had partial response and one patient progressed after 4 cycles of chemotherapy. The patient with localized disease continues to be disease free till date. Grade 3,4 neutropenia and grade 2 anemia was the most common chemotherapy related toxicity.
CONCLUSION CONCLUSIONS
The response rates in MPBC with IA regimen appear to be similar to the currently used anthracycline-taxane combinations, with slightly more haematological toxicity. Ifosfamide and adriamycin regimen may be considered in MPBC patients as primary or salvage systemic therapy.

Identifiants

pubmed: 39306877
pii: S0147-0272(24)00089-8
doi: 10.1016/j.currproblcancer.2024.101148
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

101148

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Nidhi Gupta (N)

Department of Radiotherapy and Oncology, Government Medical College and Hospital, Chandigarh, India. Electronic address: nidhiguptaonco@gmail.com.

Shifali Dogra (S)

Department of Radiotherapy and Oncology, Government Medical College and Hospital, Chandigarh, India.

Kislay Dimri (K)

Department of Radiotherapy and Oncology, Government Medical College and Hospital, Chandigarh, India.

Awadhesh Kumar Pandey (AK)

Department of Radiotherapy and Oncology, Government Medical College and Hospital, Chandigarh, India.

Jesu Susan Jose (JS)

Department of Radiotherapy and Oncology, Government Medical College and Hospital, Chandigarh, India.

R S Punia (RS)

Department of Pathology, Government Medical College and Hospital, Chandigarh, India.

Classifications MeSH