Annals of Oncology 12:69-74, 2001
© 2001 European Society for Medical Oncology
research-article |
High-dose thiotepa and melphalan with hemopoietic progenitor support following induction therapy with epirubicin–paclitaxel-containing regimens in metastatic breast cancer (MBC)
1Division of Medical Oncology
2Pharmacology and Chemotherapy, Department of Oncology, Transplants and Advanced Technologies in Medicine
3Service ofTransfusional Medicine
4Division of Pediatric Oncology/Hematology, Department of Reproductive Medicine and Development, St Chiara Hospital and University of Pisa Pisa, Italy
Dr P F Conte Division of Medical Onocology Department of Oncology Department of Oncology St Chiara University Hospital Via Roma, 67 56100 Pisa Italy
BACKGROUND: Preliminary data from phase III randomized studies have failed to show benefit of HDC given as consolidation after anthracychne and alkylating-based chemotherapy in metastatic breast cancer (MBC) Moderate activity of induction regimens and selection of chemoresistant clones are among the possible reasons for these disappointing results We therefore have designeda phase II study where high-dose alkylating agents are given as consolidation after an induction treatment including the most active agents (epirubicin and pachtaxel) without alkylating agents.
PATIENTS AND METHODS: Patients with MBC not previously treated with chemotherapy for metastatic disease were eligible After six courses of epirubicin–pachtaxel± gemcitabine patients received a course of thiotepa 600 mg/m2+melphalan 160 mg/m2 with hemopoietic support Pharmacokinetic parameters of thiotepa and melphalan were measured and related to treatment outcomes The L-VEF of the patients was monitored before and after treatment
RESULTS: Forty-eight patients have been treated. Before HDC 14 patients werein CR, and 34 in PR A median of 6 92 x106 (range 1 53–16 6) CD34+cells/kg were reinfused after HDC. Median days (range) to neutrophils >0.5x 109/l and platelets>20,000 x109/l were 9.5 (9–33) and 10 days (9–32), respectively Symptomatic CHF was observed in two patients (41%) Cmaxand AUC of thiotepa showed a linear relationship with time to progression (TTP) and overall survival (OS) r2= 0 6. After HDC the conversion rate from PR to CR was 44 1%At five years progression-free and overall survival rates are 37 5% and 65%, respectively A treatment-related death was observed
CONCLUSIONS: High-dose thiotepa and melphalan after an epirubicin-pachtaxel-containing treatment is feasible, devoid of significant cardiotoxicity and very active. Pharmacokinetic parameters of high-dose thiotepa might be linked to treatment outcome
high-dose chemotherapy, metastatic breast cancer, Pachtaxel
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  C. RUSCITTI, S. GUADAGNI, F. RUSSO, G. PALUMBO, G. FIORENTINI, A. MAMBRINI, M. CANTORE, E. KANAVOS, A. PINTO, and G. AMICUCCI Thoracic Stop-flow Perfusion for Refractory Lymphoma: A Phase I-II Evaluation Trial In Vivo, May 1, 2009; 23(3): 447 - 457. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Savier, D. Azoulay, E. Huguet, F. Lokiec, M. Gil-Delgado, and H. Bismuth Percutaneous Isolated Hepatic Perfusion for Chemotherapy: A Phase 1 Study Arch Surg, March 1, 2003; 138(3): 325 - 332. [Abstract] [Full Text] [PDF]
|
|