Docetaxel, Epirubicin, and Cyclophosphamide With or Without Trastuzumab in Treating Women With Locally Advanced Breast Cancer That Can Be Removed By Surgery

This is an interventional treatment trial for Breast Cancer focused on measuring stage IIIA breast cancer, stage IIIB breast cancer, stage IIIC breast cancer, stage II breast cancer, inflammatory breast cancer Read More

DISEASE CHARACTERISTICS:

• Histologically or cytologically confirmed primary carcinoma of the breast by core biopsy

• Solitaire or multifocal disease, defined as tumor manifestations within a quadrant or distance between tumor manifestations measured bilaterally < 4 cm, respectively

  • No multifocal primary tumor, defined as tumor manifestations in different quadrants or distance between tumor manifestations ≥ 4 cm

• Locally advanced, operable disease

  • Primary tumor ≥ 2 cm by clinical examination or imaging (i.e., mammogram, MRI, or ultrasound)

    • Inflammatory breast cancer with bidimensionally measurable lesion, independent of nodal status, allowed

• HER2 status meeting 1 of the following criteria:

  • HER2-positive disease

    • 3+ by immunohistochemistry (IHC) and/or positive by fluorescence in situ hybridization (FISH)

  • HER-2 negative disease

    • 0 or 1+ by IHC OR 2+ by IHC and negative by FISH
• No distant metastases by clinical or imaging diagnosis
• No prior breast cancer
• Hormone receptor status not specified

PATIENT CHARACTERISTICS:

• Female
• Pre- or post-menopausal
• ECOG performance status 0-2
• Platelet count ≥ 100,000/mm^3
• Neutrophil count ≥ 1,500/mm^3
• Hemoglobin ≥ 10 g/dL
• ALT and AST ≤ 1.5 times upper limit of normal (ULN)
• Alkaline phosphatase ≤ 2.5 times ULN
• Creatinine ≤ 1.5 times ULN
• Bilirubin normal (unless due to clearly documented Gilbert's syndrome)
• Not pregnant or nursing
• Negative pregnancy test (for premenopausal women or women with a postmenopausal status for < 1 year)
• Fertile patients must use effective contraception
• Adequate organ function for cytotoxic chemotherapy
• No known hypersensitivity reaction to the study agents or incorporated substances
• No known allergy or severe reactions to trastuzumab or its constituents (for patients with HER2-positive disease)
• No preexisting motor or sensory neuropathy ≥ grade 2
• No other invasive malignancy within the past 5 years that would preclude study compliance or affect the interpretation of study results
• LVEF ≥ 55% by MUGA or echocardiography

• No other serious illness or medical condition, including any of the following:

  • New York Heart Association class II-IV congestive heart failure
  • History of documented congestive heart failure
  • Unstable angina pectoris
  • Myocardial infarction within the past 12 months
  • Uncontrolled hypertension (i.e., systolic blood pressure [BP] > 180 mm Hg or diastolic BP > 100 mm Hg)
  • Clinically significant valvular heart disease
  • High-risk, uncontrolled arrhythmias
  • Dyspnea at rest due to malignant or other disease
  • Condition that requires supportive oxygen therapy
  • Active serious uncontrolled infections
  • Uncontrolled diabetes

PRIOR CONCURRENT THERAPY:

• No prior systemic therapy for cancer
• No prior trastuzumab (Herceptin^®) (for HER2-positive patients)
• No other concurrent anticancer therapy
• No other concurrent investigational drugs
• No concurrent immunosuppressive therapy
• No concurrent sex hormones
• No concurrent corticosteroids unless for premedication
• No concurrent bisphosphonates during active treatment with chemotherapy