Clinical Study

CONcurrent ChEmotherapy and RadioTherapy in adjuvant treatment of breast cancer (CONCERT): a phase 2 study

23 Feb 2023
Tabassum Wadasadawala, Anup Akanksha, Johnny Carlton, Rajiv Sarin, Sudeep Gupta, Vani Parmar, Rima Pathak, Jaya Ghosh, Jyoti Bajpai, Seema Gulia, Revathy Krishnamurthy

Purpose: This phase 2 study evaluated the safety of adjuvant chemoradiation (CTRT) for breast cancer.

Methods: From April 2019 to 2020, 60 patients with stage II–III invasive breast cancer planned for adjuvant taxane-based chemotherapy and radiotherapy (RT) were accrued. Local ± regional (excluding the internal mammary nodal region) RT (40 Gy in 15 fractions ± boost) was started with the third cycle of an adjuvant taxane in a 3-weekly schedule or with the eighth cycle in a weekly schedule.

Results: Thirty-six patients received 3-weekly paclitaxel regimen and 24 received weekly paclitaxel regimen. The commonly used technique was three-dimensional conformal RT which was employed in 58% of patients. Regional RT, including the medial supraclavicular region, was done in 42 patients (70%). No dose-limiting (grade 3 or 4) toxicity was documented and all patients completed CTRT without any treatment interruption. The median ejection fraction pre and post CTRT 6 months was 60% (p = 0.177). The median value of cardiac enzyme (Troponin T ng/L) decreased from 37 to 20 (p = 0.009) post CTRT 6 months. Of the 54 patients who underwent the pulmonary function tests, there was no significant difference in various parameters like functional vital capacity (FVC) (2.29 versus 2.2 L, p = 0.375), forced expiratory volume at 1 second (FEV1) (1.86; 1.82; p = 0.365), FEV1/FVC (81.5; 81.43; p = 0.9) and diffusion lung capacity for carbon monoxide (88.3; 87.6; p = 0.62). At a median follow-up of 34 months, the 3-year actuarial rate of disease-free survival and overall survival was 75% and 98.3%, respectively. Quality of life scores (QOL) improved after treatment for most of the domains comparable to the pre-RT scores.

Conclusion: Taxane-based adjuvant CTRT is a safe option and results in minimal toxicity and excellent compliance. It has favourable impact on cardio-pulmonary profile and QOL scores.

Related Articles

Mariana Carvalho Gouveia, Cassio Murilo Hidalgo Filho, Raquel Andrade Moreno, Heitor Castelo Branco Rodrigues Alves, Aline Sgnolf Ayres, Laura Testa, Renata Colombo Bonadio
Ralph Victor Yap, Deanne Lou Marquez, Frances Marion De La Serna
Evelyn Lilian Beas-Lozano, Haydeé Cristina Verduzco-Aguirre, Roberto Gonzalez-Salazar, Yanin Chavarri-Guerra
Fernando E Petracci, Cynthia Villarreal-Garza, Facundo Argañaraz, Gonzalo Gomez Abuin, José Peñaloza, Marcos Ariel Flores, Luciano Piazzoni, Cecilia Riggi, Lucía Fabiano, Lucía González, Belén Cieplinski, Sergio Rivero, Ernesto Korbenfeld, Pablo Mandó
Katsuki Arima Tiscoski, Juliana Giacomazzi, Matheus Soares Rocha, Gustavo Gössling, Gustavo Werutsky
Benjamín Walbaum, José Miguel Reyes, Pablo Rodriguez, Sabrina Muñiz, Lidia Medina, Carolina Ibáñez, Tomás Merino, Mauricio P Pinto, Maria Loreto Bravo, Francisco Acevedo, José Bennett, Cesar Sánchez