| Abstract | Docetaxel has proven effective in advanced breast cancer. Myelosuppression and cumulative fluid retention syndrome are troublesome, potentially avoidable toxicities. In this consecutive cohort study, docetaxel (100 mg/m2 by 1 hour i.v. infusion, q3 weeks) activity and toxicity was explored in 56 anthracycline-pretreated patients (eligible: 55: median age: 51 years [range: 28-68 years]; median performance status: 0 [range: 0-3]) with metastatic breast cancer, using two different granulocyte colony-stimulating factor and steroid pre- and postmedication schedules. Twenty-nine patients (group A) received a 5-day oral prednisone premedication, and 26 (group B) received 4-day low-dose i.m. dexamethasone; group B patients also received prophylactic granulocyte colony-stimulating factor. All patients were evaluable for toxicity and 53 for response. Prophylactic granulocyte colony-stimulating factor significantly lowered the incidence of grade III-IV neutropenia and neutropenic fever (p = 0.0001 and 0.01, respectively). The incidence of moderate-severe fluid retention syndrome was lower in patients receiving i.m. dexamethasone (p = 0.08). Overall response rate was 53% (4 complete responses/24 partial responses, 95% confidence interval 39.4-66.2%); 32% have stable disease and 15% progressive disease. In 21 anthracycline-refractory/resistant patients, as well as in 10 paclitaxel-pretreated patients, the overall response rate was 50%. Docetaxel is highly active in anthracycline- and paclitaxel-pretreated metastatic breast cancer, with manageable toxicity. Optimal use of both granulocyte colony-stimulating factor support and steroid premedication deserves further investigation. |
| Authors | V Ferraresi, M Milella, A Vaccaro, A M D'Ottavio, P Papaldo, C Nisticò, M F Thorel, A Marsella, A Carpino, D Giannarelli, E Terzoli, F Cognetti
(Affiliation: Division of Medical Oncology I, Regina Elena Cancer Institute, Rome, Italy.)
|
| Journal | American journal of clinical oncology
(Am J Clin Oncol)
Vol. 23
Issue 2
Pg. 132-9
(Apr 2000)
ISSN: 0277-3732 UNITED STATES |
| PMID | 10776972
(Publication Type: Clinical Trial, Clinical Trial, Phase II, Journal Article, Research Support, Non-U.S. Gov't)
|
| Chemical References |
- Anthracyclines
- Antineoplastic Agents, Phytogenic
- Glucocorticoids
- Taxoids
- docetaxel
- Granulocyte Colony-Stimulating Factor
- Paclitaxel
- Dexamethasone
- Prednisone
|
| Topics |
- Adult
- Aged
- Anthracyclines
(pharmacology, therapeutic use)
- Antineoplastic Agents, Phytogenic
(adverse effects, pharmacology, therapeutic use)
- Breast Neoplasms
(drug therapy, pathology)
- Cohort Studies
- Dexamethasone
(administration & dosage)
- Drug Resistance, Neoplasm
- Female
- Glucocorticoids
(administration & dosage)
- Granulocyte Colony-Stimulating Factor
(administration & dosage)
- Humans
- Infusions, Intravenous
- Middle Aged
- Neutropenia
(chemically induced, prevention & control)
- Paclitaxel
(adverse effects, analogs & derivatives, pharmacology, therapeutic use)
- Prednisone
(administration & dosage)
- Taxoids
|
