Annals of Oncology Advance Access originally published online on July 19, 2005
Annals of Oncology 2005 16(12):1979; doi:10.1093/annonc/mdi386
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© 2005 European Society for Medical Oncology
Letter to the Editor |
Reply to "Weekly paclitaxel as first-line chemotherapy in elderly advanced breast cancer patients: a phase II study of the Gruppo Italiano di Oncologia Geriatrica (GIOGer)" by L. Del Mastro et al. (Ann Oncol 2005; 16: 253–258)
As only few studies have investigated the efficacy and feasibility of chemotherapy in elderly cancer patients, the study by Del Mastro et al. [1
] on weekly paclitaxel in elderly breast cancer patients is of relevance for clinical daily practice. Their results, with a response rate of 53.7% (intention-to-treat 48%), are in a similar range to a response rate of 38% (intention-to-treat 38%) in our study using a similar weekly schedule of paclitaxel as first-line chemotherapy in 26 elderly patients with metastatic breast cancer [2]. In contrast to the high rate of cardiovascular complications reported by Del Mastro et al., we did not observe any cardiovascular toxicity, although we did not perform routine MUGA (multigated acquisition) or echocardiographic evaluation, and therefore may have missed any asymptomatic impairment of ejection fraction. The difference in toxicity cannot be explained by age: the median age of patients in the study by Del Mastro was 74 years as compared with 77 years in our study. As 24 out of 46 patients (52%) in the study by Del Mastro et al. received previous (neo-)adjuvant chemotherapy, while none of our patients had been pretreated with chemotherapy, we wonder whether the cardiovascular complications may have been correlated to pretreatment with anthracyline chemotherapy.
1 Vrije Universiteit Medisch Centrum, Amsterdam; 2 Ziekenhuis Gooi-Noord, Blaricum, The Netherlands
* E-mail: smorenburg{at}vumc.nl
References
1. Del Mastro L, Perrone F, Repetto L et al. Weekly paclitaxel as first-line chemotherapy in elderly advanced breast cancer patients: a phase II study of the Gruppo Italiano di Oncologia Geriatrica (GIOGer). Ann Oncol 2005; 16: 253–258.
2. ten Tije AJ, Smorenburg CH, Seynaeve C et al. Weekly paclitaxel as first-line chemotherapy for elderly patients with metastatic breast cancer. Eur J Cancer 2004; 40: 352–357.[CrossRef][Web of Science][Medline]
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