Review of Clinical Response in Locally Advanced and Advanced Stage Breast Cancer on Various Regiments of Chemotherapy and Subtypes: A Hospital Based Study in Tertiary Care Hospital, Indonesia

Abstract

Background: Chemotherapy is the most commonly used systemic therapy for locally advanced and advanced-stage breast cancer, not only for TNBC, HER-2 type, and luminal B, but also partly for luminal A. In Haji Adam Malik (HAM) Hospital, a tertiary care hospital, most breast cancer patients are in stages III and IV; hence, most patients receive chemotherapy. In this review, we examine the clinical response of breast cancer according to various chemotherapy regimens and subtypes of breast cancer.

Methods: A review of medical records and clinical examinations was conducted in the Surgical Oncology Division of the Department of Surgery at HAM Hospital in Medan, Indonesia, using a cross-sectional study design. Response Evaluation Criteria in Solid Tumors/RECIST was used to assess clinical response.

Result: In 2022, 107 patients met the criteria for this study, including 56 Luminal B, 23 Luminal A, 19 HER-2 type, and 9 TNBC. General clinical responses: CR(complete response), PR(partial response), SD(stable disease), and PD(progressive disease) were as follows: 2 cases(1,9%), 55 cases(51,4%), 20 cases(18,7%), and 30(28%) cases, respectively. A total of 13 chemotherapy regimens were administered; AT(Paclitaxel/Doxorubicin), TP(Docetaxel/Cisplatin), CEF(Cyclophosphamide/Epirubicin/5FU), and AC(Doxorubicin/Cyclophosphamide) were given the most. Cumulative complete and partial response for AT:64,5%,TP:28,6%,CEF:53%,and AC:58,3%. Based on subtype, the cumulative complete and partial response for TNBC 66,7%, Luminal A 60%, HER-2 type 52,6%, and Luminal B 48,2%. On regiments AT,TP,CEF,AC consecutively, benefit response (CR+PR+SD) of luminal A: 9/9(100%),2/5(40%),3/5(60%),2/2(100%); luminal B: 9/11(81,8%),8/15(53,3%),2/4(50%),4/6(66,7%); TNBC: 5/5(100%),3/3(100%),1/1(100%),0% and HER-2 type: 5/6(83,3%),1/1(100%),4/4(100%), 2/3(66,7%).

Conclusion: Paclitaxel plus doxorubicin had the highest cumulative complete and partial responses and also the highest benefit response in all subtypes of breast cancer, including TNBC.