EVALUTE THE EFFICACY OF ADJUVANT REGIMEN 3 FEC

EVALUTE THE EFFICACY OF ADJUVANT REGIMEN 3 FEC- 3 T IN STAGE II BREAST CANCER LÊ THU HÀ, Ph. D. Nguyễn Khánh Hà, Dr. Hai Phong, 2017

Introduction v Breast cancer is the most commonly diagnosed cancer in women v Global (2012): 1, 6 million new cases. v Viet Nam (2010): 18. 424 new cases. v Rate of women diagnosed at the early stage (I, II) increases, mortality rate decreases. v Adjuvant chemotherapy, hormone therapy, target therapy are the common ways to treat breast cancer after mastectomy.

Introduction v Adjuvant chemotherapy can lower the risk cancer coming back and prolong survival v Regimens in the clinical : AC , CAF , CMF , 4 AC – 4 T TAC, 3 FEC – 3 T, 4 AC , TC… v Sequencial adjuvant 3 FEC – 3 T was demonstrated efficacy in breast cancer on the World. v Ha Noi Oncology Hospital started perform 3 FEC – 3 T in 2010.

OBJECTIVE v This study is aim to evaluate the efficacy and the toxicity of 3 FEC – 3 T regimen in breast cancer patients with stage II after mastectomy.

OVERVIEW v Diagnosis v Stage TNM v Multidemensional treatment v Adjuvant chemotherapy v Clinical trials

PATIENTS AND METHOD v Patients: Restrospective study of 65 stage II breast cancer patients underwent mastectomy given 3 FEC – 3 T regimen from 10/2010 to 31/12/2014 at Ha Noi Oncology Hospital.

PATIENTS AND METHOD v Method: • Clinical presentation • Staging TNM • Surgery • Mortality and morbidity • Toxicity of regimen

RESULT AND DISCUSSION v Age Tỷ lệ % 44. 6 45 40 35 30 25 20 15 10 5 0 30. 8 13. 8 10. 8 ≤ 40 40 - 49 50 - 59 ≥ 60 Mean age : 49. 8 ± 7. 926, min: 28, max: 67

RESULT AND DISCUSSION v Tumor distance T 1: 9, 2% T 2: 84, 6% T 3: 6, 2%

Kết quả và bàn luận v Đặc điểm về di căn hạch 47. 7% 52. 3% N 0 N 1

RESULT AND DISCUSSION v Pathology 78. 4 Số lượng bệnh nhân 90% 75% 60% 45% 30% 12. 37 9. 23 0 15% 0% Độ III không xác đinh

RESULT AND DISCUSSION v Her 2 -neu Her-2 Number of patient Rate (%) Negative 37 56, 93 Positive 28 43, 07 65 100 Total

RESULT AND DISCUSSION Hormone receptor Feature No. patient Rate (%) ER Negative 25 38, 46 Positive 40 61, 54 Negative 32 49, 23 Positive 33 50, 77 65 100 PR Total 36. 92 63. 08 HR(-) HR(+)

Time to v Median follow – up time : 42, 75 ± 13, 95 months v Max : 78 months v Min : 25 months

DFS 3 years: 78, 8% DFS 5 years: 75, 6%

OS OS 3 years: 96, 8% OS 5 years: 94, 2%

RESULT AND DISCUSSION Clinical Trials PAC-01 GEICAM 9906 TACT We DFS (5 năm) 78. 4% 78. 5% 74, 3% 75. 6% OS (5 năm) 90. 7% - - 94. 2% Roche’ H et al (2006) Miguel Martín et al (2008) Ellis P et al (2009)

RESULT AND DISCUSSION Phác đồ FAC CMF 3 FEC-3 T DFS (5 năm) 70. 97% 66. 67% 75. 6% OS (5 năm) 80. 65% 76. 67% 94. 2% Nguyễn Bá Đức, Trần Văn Thuấn (2002) Trần Văn Thuấn và cs (2005) Nguyễn Thị Sang, Trần Thắng, Trần Văn Thuấn, Vũ Hồng Thăng (2014)

Correlative between DFS and N (+): 64, 7% DFS and N (-): 84, 7%

Correlative between DFS and HR v DFS and HR (+): 83, 8% v DFS and HR (-): 67, 7%.

DFS and other factors DFS và Her 2/neu DFS và T

RESULT AND DISCUSSION v Hematology toxicity 120 100 7. 7 8. 9 9. 2 11. 8 80 19. 5 19. 2 51. 8 60 40 1. 2 4. 4 0 3. 1 96. 9 63. 1 59 46. 6 20 0 Hạ bạch cầu Độ 0 Hạ BC ĐNTT Độ 1 Hạ tiểu cầu Độ 2 Hạ huyết sắc tố Độ 3 Độ 4

Toxicity Nausea 70 60 58. 4 50 40 30 20 12. 5 10 1. 5 0 Độ 3 Độ 4 0 Độ 1 Độ 2

Toxicity Liver 18 16 15. 4 14 12 10 8 6 4 1. 5 2 0 0 Độ 1 Độ 2 Độ 3 Độ 4

Toxicity Level 1 Level 2 Level 3 Level 4 No. (%) Chán ăn 40 (61, 5) 5 (7, 7) 0 0 Anoresia 50 (76, 9) 15 (23, 1) 0 0 Ure/ Creatinin 0 0 Cardiology 0 0 27 (41, 5) 10 (15, 4) 0 0 Neurosensory

Conclusion v DFS and OS improved. DFS after 3 year and 5 year are 78, 8%; 75, 6% respectivly and OS after 3 year and 5 year are 96, 8%; 94, 2%. v N (+) lead to decrease survival. DFS and N (+) is 84, 7%, DFS and N (-) is 64, 7% v DFS and HR (+) is higher than DFS and HR (-) (83, 8% và 67, 7%)

THANKS FOR YOUR ATTENTION