Martín M, Lluch A, Casado A, Garciía Carbonero I, de Paz L, Esteban C, Insa A, Alfonso R, García-Conde J, Diaz-Rubio E
Medical Oncology Department, University Hospitals of Madrid, Spain.
Ann Oncol. 2000 Jan;11(1):85-9. doi: 10.1023/a:1008374425246.
To evaluate the anti-tumour activity and tolerance of the combination of paclitaxel plus vinorelbine in metastatic breast cancer (MBC) patients previously treated with anthracyclines.
Fifty-six MBC patients who have had at least one previous anthracycline-containing chemotherapy regimen were enrolled in this phase II trial. Patients received paclitaxel (135 mg/m2 over one-hour infusion) and vinorelbine (30 mg/m2) both on day 1 of each three-week course of therapy (maximum eight courses or until disease progression was evident).
Six complete and nineteen partial responses were observed among the fifty-four assessable patients (response rate of 46%, 95% CI: 33%-60%). Responses were observed in all disease sites and in all subsets of patients. The response rates when paclitaxel plus vinorelbine were used as first, second and third-line chemotherapy for metastases were 67%, 41% and 35%, respectively. The response rate among anthracycline-refractory patients was 46% (6 of 13). Median time to progression in the overall patient group was 28 weeks. The main toxicities (CTC grade 2 or more) were alopecia, myelosuppression and peripheral neuropathy (85%, 46% and 19% of patients, respectively). Nine patients (17%) had neutropenic fever in fifteen of the three hundred twenty-eight courses administered (5%).
The combination of paclitaxel and vinorelbine on day 1 every three weeks is active in MBC patients with prior anthracycline exposure. The regimen is safe, well tolerated and convenient for the patients.
评估紫杉醇联合长春瑞滨对既往接受过蒽环类药物治疗的转移性乳腺癌(MBC)患者的抗肿瘤活性及耐受性。
56例既往至少接受过一种含蒽环类药物化疗方案的MBC患者入组该II期试验。患者在每3周疗程的第1天接受紫杉醇(135mg/m²,静脉滴注1小时)和长春瑞滨(30mg/m²)治疗(最多8个疗程或直至疾病进展明显)。
在54例可评估患者中观察到6例完全缓解和19例部分缓解(缓解率为46%,95%CI:33%-60%)。在所有疾病部位和所有患者亚组中均观察到缓解。当紫杉醇联合长春瑞滨用作转移灶的一线、二线和三线化疗时,缓解率分别为67%、41%和35%。蒽环类药物难治性患者的缓解率为46%(13例中的6例)。总体患者组的中位疾病进展时间为28周。主要毒性(CTC 2级或更高)为脱发、骨髓抑制和周围神经病变(分别占患者的85%、46%和19%)。在328个疗程中的15个疗程(5%)有9例患者(17%)发生中性粒细胞减少性发热。
每3周第1天使用紫杉醇和长春瑞滨联合方案对既往接受过蒽环类药物治疗的MBC患者有活性。该方案安全、耐受性良好且对患者方便。