International Journal of Medical Sciences

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14 December 2017

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Int J Med Sci 2013; 10(2):110-118. doi:10.7150/ijms.5123

Research Paper

Dynamic Contrast-Enhanced MR Imaging in a Phase Ⅱ Study on Neoadjuvant Chemotherapy Combining Rh-Endostatin with Docetaxel and Epirubicin for Locally Advanced Breast Cancer

Qianxin Jia1,2*, Junqing Xu1*, Weifeng Jiang3, Minwen Zheng1, Mengqi Wei1, Jianghao Chen4, Ling Wang4, Yi Huan1✉

1. Department of Radiology, Xijing Hospital, Fourth Military Medical University. 17 Changle Western Road, Xi'an, China.
2. Department of Radiology, Dongnan Hospital, Xiamen University. 269 Zhanghua Middle Road, Zhangzhou, China.
3. Department of Rehabilitation, Guangzhou Sanatorium of Guangzhou Military Region.1849 Guangzhou Avenue, Guangzhou, China.
4. Department of General Surgery, Xijing Hospital, Fourth Military Medical University. 17 Changle Western Road, Xi'an, China.
* Equal study contribution.

Abstract

Background: Anti-angiogenesis is a promising therapeutic strategy for locally advanced breast cancer. We performed this phase II trial to evaluate the anti-angiogenesis and anti-tumor effect of rh-endostatin combined with docetaxel and epirubicin in patients with locally advanced breast cancer by dynamic contrast-enhanced magnetic resonance imaging in 70 previously untreated locally advanced breast cancer patients.

Methods: The study population was randomly assigned to neoadjuvant chemotherapy with docetaxel and epirubicin (neoadjuvant chemotherapy group) or neoadjuvant chemotherapy combining rh-endostatin with docetaxel and epirubicin (neoadjuvant chemotherapy+rh-endostatin group). The anti-angiogenic and anti-tumor effects of both regimens were evaluated by serial dynamic contrast-enhanced magnetic resonance imaging and microvessel density measurements after final surgery.

Results: The results suggested a higher clinical objective response (90.9% vs. 67.7%, P = 0.021) and greater reductions in tumor size (67.2% vs. 55.9%, P = 0.000), Ki-67 proliferation index (32.79% vs. 12.47%, P = 0.000), tumor signal enhanced ratio (64% vs. 48%, P = 0.018), and Ktrans (67% vs. 39%, P = 0.026) in neoadjuvant chemotherapy+rh-endostatin group than those in neoadjuvant chemotherapy group. In addition, the microvessel density value in the neoadjuvant chemotherapy+rh-endostatin group was significantly lower than in the neoadjuvant chemotherapy group (18.67 ± 6.53 vs. 36.05 ± 9.64, P = 0.000). Moreover, the microvessel density value was significantly correlated with Ktrans after neoadjuvant chemotherapy+rh-endostatin treatment (r=0.88, P = 0.00).

Conclusions: The neoadjuvant chemotherapy+rh-endostatin treatment significantly repressed angiogenesis in locally advanced breast cancer and synergistically enhanced the anti-tumor effect of neoadjuvant chemotherapy. Serial dynamic contrast-enhanced magnetic resonance imaging data including reductions in tumor size and Ktrans, could provide non-invasive evaluation for chemotherapeutic efficacy and, consequently, optimization of individual chemotherapy for locally advanced breast cancer patients.

Keywords: breast cancer, neoadjuvant chemotherapy, rh-endostatin, microvessel density, dynamic contrast-enhanced MR imaging

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How to cite this article:
Jia Q, Xu J, Jiang W, Zheng M, Wei M, Chen J, Wang L, Huan Y. Dynamic Contrast-Enhanced MR Imaging in a Phase Ⅱ Study on Neoadjuvant Chemotherapy Combining Rh-Endostatin with Docetaxel and Epirubicin for Locally Advanced Breast Cancer. Int J Med Sci 2013; 10(2):110-118. doi:10.7150/ijms.5123. Available from http://www.medsci.org/v10p0110.htm