Vinorelbine and paclitaxel as first-line chemotherapy in metastatic breast cancer

被引:41
作者
Acuña, LR [1 ]
Langhi, M [1 ]
Pérez, J [1 ]
Acuña, JR [1 ]
Machiavelli, M [1 ]
Lacava, J [1 ]
Vallejo, C [1 ]
Romero, A [1 ]
Fasce, H [1 ]
Ortiz, E [1 ]
Grasso, S [1 ]
Amato, S [1 ]
Rodríguez, R [1 ]
Barbieri, M [1 ]
Leone, B [1 ]
机构
[1] Grp Oncol Cooperat Sur Neuquen, RA-8300 Neuquen, Argentina
关键词
D O I
10.1200/JCO.1999.17.1.74
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To evaluate the efficacy and toxicity of a combination of vinorelbine (VNB) and paclitaxel (PTX) as first-line chemotherapy in metastatic breast carcinoma (MBC). Patients and Methods:: Between August 1995 and August 1997, 49 patients with untreated MBC received a regimen that consisted of VNB 30 mg/m(2) in a 20-minute intravenous (IV) infusion on days 1 and 8 and PTX 135 mg/m(2) in a 3-hour IV infusion (starting 1 hour after VNB) on day 1. Cycles were repeated every 28 days. The median age of the patients was 52 years, and 59% of patients were postmenopausal. Median performance status was 1. Dominant sites of disease were soft tissue in 6%, bone in 29%, and viscera in 65%. Results: Objective responses were recorded in 27 of 45 assessable patients (60%; 95% confidence interval, 46% to 74%). Complete remissions occurred in three patients (7%), and partial remissions occurred in 24 patients (53%). No change was recorded in 12 patients (27%), and progressive disease occurred in six patients (13%). The median time to treatment failure was 7 months, and median survival duration was 17 months. The limiting toxicity was myelosuppression, mainly leukopenia in 49 patients (100%) (grade 1 to grade 2, four patients; grade 3, 30 patients; and grade 4, 15 patients). Neutropenia was observed in 100% of patients (grade 1 to grade 2, three patients; grade 3, 11 patients; grade 4, 35 patients). Two treatment-related deaths due to febrile neutropenia were observed in patients with massive liver involvement. Peripheral neurotoxicity developed in 33 patients (67%) (grade 1, 25 patients; grade 2, eight patients); there were no grade 3 or grade 4 episodes. Conclusion: The combination of VNB-PTX showed significant activity as first-line chemotherapy for patients with MBC. Myelosuppression was the dose-limiting side effect, whereas neurotoxicity was mild to moderate. J Clin Oncol 17:74-81. (C) 1999 by American Society of Clinical Oncology.
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页码:74 / 81
页数:8
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