Weekly docetaxel/paclitaxel in pretreated metastatic breast cancer.
Weekly docetaxel/paclitaxel in pretreated metastatic breast cancer.
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DOI：
10.3816/cbc.2002.n.038
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发表时间：
2002-12-01
影响因子：
3.1
通讯作者：
Conte, Pier Franco
中科院分区：
文献类型：
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作者：
Gennari, Alessandra;Guarneri, Valentina;Conte, Pier Franco
本研究的目的是评估每周一次多西他赛/紫杉醇治疗预治疗的晚期乳腺癌患者的可行性和疗效。本研究纳入了26例转移性乳腺癌患者。给予三种不同的治疗方案。起始方案A1包括第1天多西他赛60 mg/m2+紫杉醇60 mg/m2 1小时，每周一次，持续18周;如果至少70%的计划剂量按时给药且未减量，则认为该方案可行。方案A2包括每3周一次在第1天和第8天给予相同剂量，方案B包括多西他赛25 mg/m2，随后每3周一次在第1天和第8天给予紫杉醇40 mg/m2 1小时，共6个周期。所有患者既往均接受过蒽环类药物治疗，19例患者接受过紫杉烷类药物治疗。77%的患者既往接受过至少2线化疗。25例患者可评估毒性和疗效。共进行了109个周期的化疗，每例患者的中位数为4个周期（范围，1-8个周期）。紫杉醇的中位递送剂量强度为27 mg/m2/周（范围：18-50 mg/m2/周），多西他赛为17 mg/m2/周（范围：12-39 mg/m2/周）。6例患者接受A1方案。由于中性粒细胞减少症2级、粘膜炎和腹泻2级，该方案被认为是不可行的，这需要在33%的给药中减少/省略剂量。因此，在第15天省略了以下5例患者的治疗（方案A2）。发现方案B更可行，剂量减少/遗漏率为16%。总体缓解率为68%（95% CI，50%-86%），中位缓解持续时间为10个月（范围，2-18+个月）。治疗耐受性良好;骨髓抑制罕见，仅在2例患者中观察到3级皮肤毒性。总之，每周一次多西他赛/紫杉醇在低剂量下具有活性，并且作为转移性乳腺癌的挽救化疗耐受性良好。该方案是紫杉烷和蒽环类药物预治疗患者的有效挽救治疗选择。
The purpose of our study was to evaluate the feasibility and efficacy of weekly docetaxel/paclitaxel in pretreated advanced breast cancer patients. Twenty-six patients with metastatic breast cancer were included in this study. Three different schedules of treatment were administered. The starting schedule, A1, consisted of docetaxel 60 mg/m2 on day 1 plus paclitaxel 60 mg/m2 over 1 hour, weekly for 18 weeks; this schedule was considered feasible if at least 70% of the planned doses were given on time and without reduction. Schedule A2 consisted of the same doses administered on days 1 and 8 every 3 weeks, and schedule B consisted of docetaxel 25 mg/m2 followed by paclitaxel 40 mg/m2 for 1 hour on days 1 and 8 every 3 weeks for a total of 6 cycles. All patients had received prior anthracyclines, and 19 patients were pretreated with taxanes. Seventy-seven percent of patients had received at least 2 prior lines of chemotherapy. Twenty-five patients are assessable for toxicity and efficacy. A total of 109 cycles of chemotherapy have been administered, with a median of 4 cycles per patient (range, 1-8 cycles). The median delivered dose intensity was 27 mg/m2/week for paclitaxel (range, 18-50 mg/m2/week) and 17 mg/m2/week (range, 12-39 mg/m2/week) for docetaxel. Six patients received schedule A1. This schedule was considered not feasible due to neutropenia grade > 2, mucositis, and diarrhea grade 2, which required dose reduction/omission in 33% of administrations. For this reason, treatment in the following 5 patients was omitted on day 15 (schedule A2). Schedule B was found to be more feasible with 16% of dose reductions/omissions. The overall response rate was 68% (95% CI, 50%-86%) with a median duration of response of 10 months (range, 2-18+ months). Treatment was well tolerated; myelosuppression was rare and grade 3 cutaneous toxicity was observed in only 2 patients. In conclusion, weekly docetaxel/paclitaxel is active at low dosages and was well tolerated as salvage chemotherapy in metastatic breast cancer. This regimen represents a valid option as a salvage treatment in taxane- and anthracycline-pretreated patients.