Dose-dense epirubicin and cyclophosphamide followed by weekly Paclitaxel in node-positive breast cancer

Dose-Dense Docetaxel versus Weekly Paclitaxel following Dose-Dense Epirubicin and Cyclophosphamide as Adjuvant Chemotherapy in Node-Positive Breast Cancer Patients: A Retrospective Cohort Analysis

Methods

This study included patients from two prospective studies conducted in our institute from April 2007 to March 2009. Ninety-one women with axillary lymph node-positive breast cancer who had received four cycles of dose-dense epirubicin and cyclophosphamide were treated with either weekly paclitaxel (80 mg/m²) for 12 doses or biweekly docetaxel (75 mg/m²) for four cycles.

Results

After a median follow-up of 88 and 109 months, 11 (23.4%) and 10 (22.7%) patients had experienced disease recurrence (p = 0.16), while 10 (21.3%) and 5 (11.4%) patients had died in the paclitaxel and docetaxel arm, respectively (p = 0.56). No significant difference could be seen in 5-year DFS or OS among groups (HR: 0.58; 95% CI: 0.19–1.81, p = 0.35; HR: 0.58; 95% CI: 0.19–1.81, p = 0.35, respectively).

Conclusion

In conclusion, both evaluated adjuvant chemotherapy regimens have comparable effectiveness regarding DFS and OS.

Effects of Oleuropein on Epirubicin and Cyclophosphamide Combination Treatment in Rats

Objectives

Oleuropein is the main bioactive polyphenolic compound in olive leaves, olive, and olive oil. Its anticancer, antioxidant, and antiinflammatory effects have been proven through several in vitro and in vivo studies. This study aimed to explore the effects of oleuropein on cyclophosphamideand epirubicin-induced toxicity in female rats.

Materials and Methods

Seven groups containing eight rats in each group were formed. Four cycles of 16 mg/kg/week of cyclophosphamide and 2.5 mg/kg/week of epirubicin were administered to the rats through intraperitoneal injection. Oleuropein (150 mg/kg/week) was simultaneously applied via oral gavage. The effects of oleuropein were examined with hemogram tests in whole blood samples and biochemical analysis in serum samples. Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the serum samples were analyzed through enzyme-linked immunosorbent assay. Subsequently, a comet assay was performed using lymphocyte DNA. The levels of oxidant [i.e., malondialdehyde (MDA)] and antioxidants [i.e., catalase (CAT), glutathione (GSH), and superoxide dismutase (SOD)] were measured in the heart, kidney, and liver tissues.

Results

Oleuropein could reduce DNA damage and serum TNF-α and IL-6 levels. It also ameliorated some hemogram and biochemical parameters that deteriorated due to antineoplastic drugs. It increased the amounts of antioxidants (GSH, SOD, and CAT) and reduced the level of MDA in the heart, kidney, and liver tissues.

Conclusion

Oleuropein might be a beneficial agent against toxicity caused by the combination treatment of cyclophosphamide and epirubicin. Further studies should be performed to demonstrate the protective effects of oleuropein against antineoplastic induced-toxicity precisely.