Does the addition of human endostatin to chemotherapy before surgery benefit patients with stage III breast cancer?

This trial was carried out to examine the use of recombinant human (rh) endostatin (EN) with CT before surgery in patients with breast cancer (BC). The authors concluded that the addition of EN to CT significantly improved the response rate to therapy and survival in these patients.

BC is the most common form of cancer found in women. Stage III BC remains a difficult disease to treat. The standard care of stage III BC is CT followed by surgical removal of tumors. More than 25% of patients with stage III BC experience disease progression and disease spread (metastasis). The development of new blood vessels in BC can contribute to its progression and spread around the body.

EN is a protein that blocks the development of new blood vessels. It blocks the movement of tumor cells and can result in an increased destruction of tumor cells. The effectiveness of adding EN to standard CT before surgery in women with stage III BC remains under investigation.

There were 87 patients enrolled in this trial. 44 patients were treated with CT and EN. 43 patients were treated with CT alone. The CT regimen included docetaxel (Taxotere), epirubicin (Ellence), and cyclophosphamide (Cytoxan). The average follow-up was 54 months in this trial. 

Patients in the CT+EN group had a significantly higher overall response rate (ORR) compared to the CT alone group (81.82% vs. 58.14%). There was a significantly longer time without relapse with CT+EN (67.3 months) compared to CT alone (55 months). Overall survival was also significantly longer with CT+EN (74.2 months) compared to CT alone (59.1 months). 

After surgery to remove the tumor, significantly more patients in the CT+EN group achieved a pathological complete response (pCR; the absence of cancer cells after surgery) compared to the CT alone group (15.9% vs. 7.0%). 

There was no significant difference in the occurrence of side effects between both groups.

The authors found that the combination of CT+EN before surgery significantly improved the responses and survival in patients with stage III BC. 

This study was carried out on Chinese patients which means this treatment may not transfer well to a global population. The number of participants was also low. Further studis are needed.