Oncology
Clinical Study
Sequential Administration of Doxorubicin and Paclitaxel Followed by Cyclophosphamide, Methotrexate and 5-Fluorouracil Combination (CMF) in Women with Metastatic Breast CancerPapadimitriou C.A.a · Dimopoulos M.A.a · Ampela C.b · Louvrou-Fertaki A.b · Anagnostopoulos A.a · Athanassiades P.a · Stamatelopoulos S.a · Keramopoulos A.bDepartments of a Clinical Therapeutics and b Obstetrics and Gynecology, Alexandra Hospital, Athens University School of Medicine, Athens, Greece
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Article / Publication Details
Published online: October 22, 1998
Issue release date: November – December
Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 4
ISSN: 0030-2414 (Print)
eISSN: 1423-0232 (Online)
For additional information: https://www.karger.com/OCL
Abstract
Although the combination of paclitaxel with doxorubicin has yielded high response rates in metastatic breast cancer, severe cardiotoxic events have been reported in several patients. The rationale for our study was to evaluate the activity of paclitaxel/doxorubicin combination in patients with this disease but to avoid excessive cardiotoxicity. Therefore, we administered 4 cycles of doxorubicin/paclitaxel followed by 6 cycles of standard cyclophosphamide, methotrexate and 5-fluorouracil (CMF) regimen. Study medication consisted of doxorubicin 60 mg/m2 as a 15-min intravenous infusion followed by paclitaxel 175 mg/m2 as a 3-hour infusion. CMF regimen consisted of cyclophosphamide 600 mg/m2 as 1-hour intravenous infusion followed by methotrexate 40 mg/m2 and 5-fluorouracil 600 mg/m2 bolus injection. The main toxicity of doxorubicin/paclitaxel treatment phase was neutropenia (WHO grade 3/4, 58%), but we observed only one cardiac adverse event. Toxicities of the CMF treatment phase were not significant. Of 24 patients evaluable for response, 2 (8%) had complete responses and 11 (46%) achieved partial response. Ten additional patients (42%) had stable disease. The median time to progression was 12 months and the median overall survival was 18.5 months. The sequential administration of doxorubicin and paclitaxel followed by CMF appeared active and well tolerated in patients with metastatic breast cancer.
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References
- Hortobagyi GN: Multidisciplinary management of advanced primary and metastatic breast cancer. Cancer 1994;74:416–423.
-
Henderson IC: Chemotherapy of metastatic disease; in Harris JR, Hellman S, Henderson IC (eds): Breast Diseases, ed 2. Philadelphia, Lippincott, 1991, pp 604–667.
-
Harris JR, Morrow M, Norton L: Malignant tumors of the breast; in De Vita VT Jr, Hellman S, Rosenberg SA (eds): Cancer: Principles and Practice of Oncology, ed 5. Philadelphia, Lippincott, 1997, pp 1557–1616.
- Holmes FA, Walters RS, Theriault RL, Forman AD, Newton LK, Raber MN, et al: Phase II trial of taxol, an active drug in the treatment of metastatic breast cancer. J Natl Cancer Inst 1991;83:1797–1805.
-
Buzdar AU, Holmes FA, Hortobagyi GN: Paclitaxel in the treatment of metastatic breast cancer: MD Anderson Cancer Center experience. Semin Oncol 1995;22(suppl 6):101–104.
-
Sledge GW Jr, Robert N, Sparano JA, Cogleigh M, Goldstein LJ, Neuberg D, et al: Eastern Cooperative Oncology Group studies of paclitaxel and doxorubicin in advanced breast cancer. Semin Oncol 1995;22(suppl 6):105–108.
- Gianni L, Munzone E, Capri G, Fulfaro F, Tarenzi E, Villani F, et al: Paclitaxel by 3-hour infusion in combination with bolus doxorubicin in women with untreated metastatic breast cancer: High antitumor efficacy and cardiac effects in a dose-finding and sequence-finding study. J Clin Oncol 1995;13:2688–2699.
- Fisherman JS, Cowan KH, Noone M, Denicoff A, Berg S, Poplack D, et al: Phase I/II study of 72-hour infusional paclitaxel and doxorubicin with granulocyte colony-stimulating factor in patients with metastatic breast cancer. J Clin Oncol 1996;14:774–782.
- Gehl J, Boesgaard M, Paaske T, Vittrup Jensen B, Dombernowsky P: Combined doxorubicin and paclitaxel in advanced breast cancer: Effective and cardiotoxic. Ann Oncol 1996;7:687–693.
- Miller AD: Reporting results of cancer treatment. Cancer 1981;47:207–214.
-
Kaplan EL, Meier P: Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958;53:457–481.
-
Reichman BS, Seidman AD, Cron JPA: Paclitaxel and recombinant granulocyte colony-stimulating factor as initial chemotherapy for metastatic breast cancer. Semin Oncol 1993;11:1943–1951.
-
Holmes FA, Frye D, Valero V, et al: Phase I study of taxol and doxorubicin for metastatic breast cancer. Proc Ann Soc Clin Oncol 1992;12:60(abstr 66).
-
Sledge GW Jr, Robert N, Sparano JA, et al: Paclitaxel (taxol)/doxorubicin combination in advanced breast cancer: The Eastern Cooperative Oncology Group experience. Semin Oncol 1994;21(suppl 8):15–18.
- Seidman AD: The emerging role of paclitaxel in breast cancer therapy. Clin Cancer Res 1995;1:247–256.
- Bonadonna G, Zambetti M, Valagussa P: Sequential or alternating doxorubicin and CMF regimens in breast cancer with more than three positive nodes: Ten-year results. JAMA 1995;273:542–547.
-
Gianni L, Capri G: Experience of the Instituto Nationale Tumori with paclitaxel in combination with doxorubicin in women with untreated breast cancer. Semin Oncol 1997;24(suppl 3):1–3.
-
Sledge GW Jr, Neuberg D, Ingle J, Martino S, Wood W: Phase III trial of doxorubicin (A) vs. paclitaxel (T) vs. doxorubicin+paclitaxel (A+T) as first-line therapy for metastatic breast cancer; an intergroup trial. Proc Ann Soc Clin Oncol 1997;16:1(abstr 2).
Article / Publication Details
Published online: October 22, 1998
Issue release date: November – December
Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 4
ISSN: 0030-2414 (Print)
eISSN: 1423-0232 (Online)
For additional information: https://www.karger.com/OCL
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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