Annals of Oncology 10:1457-1460, 1999
© 1999 European Society for Medical Oncology
research-article |
Docetaxel–cisplatin combination (DC) chemotherapy in patients with anthracycline-resistant advanced breast cancer
Institut Gustave Roussy Villejuif, France
Correspondence to: M. Spielmann, MD, Institut Gustave Roussy, Rue Camille Desmoulins, 94800 Villejuif, France
Purpose: The safety and efficacy of a docetaxel-cisplatin combination (DC) were evaluated in 41 patients pretreated for advanced breast cancer (ABC).
Patients and methods: The first 2 patients received 85 mg/m2 docetaxel followed, 6 hours later, by 80 mg/m2 cisplatin repeated every 3 weeks; the other 39 received the same regimen, with 75 mg/m2 docetaxel. Appropriate dose reductions but no growth factor administration were planned. Treatment was continued until disease progression, excessive toxicity or patient refusal.
Results: A total of 223 chemotherapy courses were administered, with a median of 6 cycles per patient (range 1–8). All 41 patients were assessed for toxicity using NC1-CTC. Severe neutropenia was experienced by 38 patients (93%) (11 at grade 3, 27 at grade 4, 10 with febrile neutropenia). There was one death due to neutropenic septic shock. Grade 3 thrombocytopenia occurred in three patients (7%). Five patients (12%) had grade 2 neurosensory toxicity, two (5%) experiencing partial hearing loss. Grade 3 fluid retention occurred in three patients (7%).
Of 38 anthracycline-resistant patients, 33 were evaluable for response. Two had a complete response (CR) and ten a partial response (PR), giving an objective response rate of 36%, (95% CI: 20%–55%). Stable disease (SD) was observed in 14 patients (42%), 7 (21%) had progressive disease (PD). Among the three non-resistant patients, two PRs and one SD were observed. Median duration of response was 29 weeks (range 18–70), median time to progression 21 weeks (4–70), and median overall survival 50 weeks (4–104+).
Conclusions: This DC regimen is active, with an acceptable safety profile in anthracycline-resistant ABC patients. Its place as a second-line treatment alternative to docetaxel alone or to other second-line combination regimens remains to be determined.
salvage chemotherapy, second-line treatment, taxanes
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