Abstract P1-11-18: Neoadjuvant Use of 5-Fluorouracil/Epirubicin/Cyclophosphamide (FEC) Followed by Docetaxel (T) with Concurrent COX-2 Inhibitor in Women with Stage II/III Breast Cancer: A Sub-Analysis of Cardiac Function

BACKGROUND: Anthracycline and taxane have been widely used and studied in neoadjuvant setting for treatment of locally advanced breast cancer. Although addition of COX-2 inhibitors might enhance the anticancer effect of chemotherapy, many studies were halted with the concern of possible cardiotoxicity. This sub-study is to evaluate the change in cardiac function of patients during treatment with pre-operative FEC-T with concurrent celecoxib until and after surgery. METHODS: A group of 47 patients, age ranged from 33 to 58 years (mean age 46±6 years), who received four cycles of 3-weekly FEC followed by four cycles of 3-weekly T with concurrent oral celecoxib before surgery (F: 500mg/m 2 ; E: 100mg/m 2 ; C: 500mg/m 2 ; T: 100mg/m 2 ; Celecoxib: 200mg bid), were studied. Echocardiography was performed at baseline, after 4 cycles of FEC and after 4 cycles of T before surgery, and 6 months, 12 months and 18 months after surgery to evaluate changes in left ventricular ejection fraction (LVEF) across time-points. Paired sample statistics was conducted. RESULTS: Patients tolerated well with this regimen. Neither life-threatening toxicity nor clinical symptom of cardiac toxicity was observed. Of 47 evaluable cases, LVEF was assessed in 47 patients pre-operatively and in 32 patients post-operatively. During concurrent celecoxib treatment, the mean LVEF increased from 68.5%±6.6% at baseline to 72.3%±3.6% after FEC and to 73.0%±4.1% after T. When compared to baseline, the changes were statistically significant after FEC (p=0.002 ) and after T (P CONLCUSIONS: Neoadjuvant FEC-T with concurrent celecoxib is well-tolerated. The short-term treatment increased LVEF during the course of neoadjuvant chemotherapy and remains good LVEF after surgery. This is an interesting finding which warrants further investigation of the possible protective effect on cardiac function. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-11-18.