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Salvage chemotherapy with paclitaxel, vinorelbine, and cisplatin (PVC) in anthracycline-resistant advanced breast cancer.

Abstract
The tolerance and the efficacy of the paclitaxel-vinorelbine-cisplatin combination (PVC regimen) was evaluated in 33 patients with anthracycline-resistant stage IV breast cancer, who had disease progression under anthracycline- or mitoxantrone-based chemotherapy. Fourteen (42%) and 19 (58%) patients had primary and secondary resistance to anthracyclines, respectively; 70% had visceral metastases. Patients received vinorelbine (25 mg/m2) followed by paclitaxel (135 mg/m2) in a 3-hour infusion on day 1, and cisplatin (CDDP; 80 mg/m2) on day 2, in a 3-week schedule. A total of 208 chemotherapy courses were administered (median six courses per patient). Grade 3/4 neutropenia occurred in 13 patients (39%), seven of whom were hospitalized for neutropenic fever (5% of the courses). There was no toxic death. Grade 4 thrombocytopenia occurred in two patients (6%) and grade 3 anemia in three patients (9%). Grade 2 and 3 neurosensory toxicity occurred in 11 patients (32%) and two patients (6%), respectively, and grade 3/4 fatigue was observed in four patients (12%). Two (6%) complete and 17 partial responses (52%) (total, 58%; 95% confidence interval, 42%-75%) were documented. Stable disease was observed in eight patients (24%) and progression in six patients (18%). The median duration of response was 6.5+ months. The median survival was 15+ months, and the 1-year survival was 67%. In conclusion, PVC regimen is an active and well-tolerated salvage chemotherapy in patients resistant to anthracycline.
AuthorsC Kourousis, S Kakolyris, N Androulakis, P Heras, J Vlachonicolis, L Vamvakas, M Vlata, D Hatzidaki, G Samonis, V Georgoulias
JournalAmerican journal of clinical oncology (Am J Clin Oncol) Vol. 21 Issue 3 Pg. 226-32 (Jun 1998) ISSN: 0277-3732 [Print] United States
PMID9626786 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Antibiotics, Antineoplastic
  • Taxoids
  • Vinblastine
  • Paclitaxel
  • Cisplatin
Topics
  • Adult
  • Aged
  • Antibiotics, Antineoplastic (therapeutic use)
  • Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
  • Breast Neoplasms (drug therapy, mortality, pathology)
  • Cisplatin (adverse effects, therapeutic use)
  • Drug Resistance, Neoplasm
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Metastasis
  • Paclitaxel (adverse effects, therapeutic use)
  • Patient Compliance
  • Salvage Therapy (adverse effects)
  • Survival Analysis
  • Taxoids
  • Vinblastine (adverse effects, analogs & derivatives, therapeutic use)

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