Lortholary A, Maillard P, Delva R, Boisdron-Celle M, Perard D, Vernillet L, Besenval M, Gamelin E
Centre Paul Papin, 2 rue Moll, F-49033, Angers, France.
Eur J Cancer. 2000 Sep;36(14):1773-80. doi: 10.1016/s0959-8049(00)00176-3.
This phase I study evaluated the maximum tolerated dose, dose-limiting toxicity and recommended dose of docetaxel in combination with 5-fluorouracil (5-FU) in patients with metastatic breast cancer previously treated with anthracycline-based chemotherapy. 32 patients received docetaxel at 60, 75, 85 or 100 mg/m(2) by 1-h intravenous (i.v.) infusion, followed, after a 1-h interval, by 5-FU at 250, 350, 500 or 750 mg/m(2)/day by continuous infusion over 5 days every 3 weeks. Dose-limiting stomatitis defined the maximum tolerated dose at a docetaxel dose of 100 mg/m(2) with 5-FU 750 mg/m(2)/day. None of 5 patients treated at the previous dose level (docetaxel 85 mg/m(2) with 5-FU 750 mg/m(2)/day) had a dose-limiting toxicity in the first cycle, and this was, therefore, considered the recommended dose. The combination was generally well tolerated. Grade 4 neutropenia was common (29 patients; 91%), but no patient experienced febrile neutropenia of duration >3 days requiring i.v. antibiotics. An objective response was achieved by 18 patients overall (56%), and in 4 out of 5 patients treated with the determined recommended dose. No pharmacokinetic interaction between docetaxel and 5-fluorouracil was apparent. The activity of docetaxel 85 mg/m(2) with 5-fluorouracil 750 mg/m(2)/day will be explored more extensively in phase II studies of patients with metastatic breast cancer previously treated with anthracycline-based chemotherapy.
本I期研究评估了多西他赛联合5-氟尿嘧啶(5-FU)在先前接受过蒽环类化疗的转移性乳腺癌患者中的最大耐受剂量、剂量限制性毒性和推荐剂量。32例患者接受多西他赛60、75、85或100mg/m²静脉滴注1小时,间隔1小时后,每3周连续5天给予5-FU 250、350、500或750mg/m²/天。剂量限制性口腔炎确定了多西他赛剂量为100mg/m²联合5-FU 750mg/m²/天时的最大耐受剂量。先前剂量水平(多西他赛85mg/m²联合5-FU 750mg/m²/天)治疗的5例患者在第一个周期均未出现剂量限制性毒性,因此,该剂量被视为推荐剂量。该联合方案总体耐受性良好。4级中性粒细胞减少很常见(29例患者;91%),但没有患者出现持续超过3天需要静脉使用抗生素的发热性中性粒细胞减少。总体上18例患者(56%)获得客观缓解,在接受确定的推荐剂量治疗的5例患者中有4例缓解。多西他赛和5-氟尿嘧啶之间未发现明显的药代动力学相互作用。多西他赛85mg/m²联合5-氟尿嘧啶750mg/m²/天的活性将在先前接受过蒽环类化疗的转移性乳腺癌患者的II期研究中进行更广泛的探索。