Background and Aims: Dose-dense neoadjuvant chemotherapy is increasingly used in locally advanced breast cancer. However, there are few studies of using paclitaxel liposome in dose-dense neoadjuvant chemotherapy. Therefore, this study was conducted to compare the safety and efficacy of dose-dense anthracycline followed by paclitaxel liposome regimen and anthracycline followed by docetaxel regimen for neoadjuvant chemotherapy in patients with locally advanced HER-2 negative breast cancer. 
Methods: The clinical data of patients with resectable locally advanced HER-2 negative breast cancer treated from January 2017 to December 2018 were retrospectively collected. All patients received 8 cycles of neoadjuvant chemotherapy. There are 196 cases received anthracycline followed by docetaxel regimen (docetaxel group), and 48 cases received dose-dense anthracycline followed by paclitaxel liposome regimen (paclitaxel liposome group). After the baseline characteristics between two groups were adjusted using 1:1 propensity score matching (PSM) approach, the pathological completed response (pCR) and clinical efficacy as well as the incidence of adverse were compared between the two groups of patients.
Results: There were 48 patients in each group after a 1:1 PSM analysis. There was no significant difference in pCR rates between the two groups (22.9% vs. 18.8%, P>0.05); the objective response rate (ORR) and disease control rate (DCR) were 93.7% and 100.0% in docetaxel group, and both ORR and DCR were 100.0% in paclitaxel liposome group, which showed no statistical differences between the two groups (P>0.05). The incidence rates of grade III-IV leucopenia and neutropenia, as well as the incidence rates of nausea, vomiting, fatigue and oral mucositis in docetaxel group were significantly higher than those in paclitaxel liposome group (all P<0.05), but no significant differences were noted in incidence rates of other adverse reactions between the two groups (all P>0.05).
Conclusion: Anthracycline followed by docetaxel regimen and dose-dense anthracycline followed by paclitaxel liposome regimen have similar efficacy in neoadjuvant chemotherapy for locally advanced HER-2 negative breast cancer. The safety of dose-dense anthrancycline followed by paclitaxel liposome regimen is obviously superior to that of anthrancycline followed by docetaxel regimen. Paclitaxel liposome can be used as a first choice of paclitaxel options in neoadjuvant chemotherapy regimen for HER-2 negative breast cancer.