Vici P, Belli F, Di Lauro L, Amodio A, Conti F, Foggi P, Gionfra T, Morelli M F, Botti C, Ferraironi A, Lopez M
Department of Medical Oncology II, Regina Elena Institute for Cancer Research, Rome, Italy.
Oncology. 2001;60(1):60-5. doi: 10.1159/000055298.
To better determine docetaxel activity in patients with well-defined anthracycline-resistant breast cancer.
From October 1996, we carried out a phase II trial in 69 heavily pretreated patients with advanced breast cancer with docetaxel 100 mg/m(2) by a 1-hour infusion on day 1, with cycles repeated every 3 weeks. Patients were classified as having primary anthracycline resistance (n = 32), secondary anthracycline resistance (n = 7), anthracycline pretreatment (n = 22) or no anthracycline pretreatment (n = 8).
Among 68 evaluable patients, we observed 6 (9%) complete responses and 27 (40%) partial responses, for an overall response rate of 49% (95% confidence interval 37-61%); the disease remained stable in 17 patients (25%). Responses according to the above subgroups were as follows: primary anthracycline resistance 41%, secondary anthracycline resistance 43%, anthracycline pretreatment 64% and no anthracycline pretreatment 43%. The median time to response, median time to progression and median overall survival were 2, 7 and 10 months, respectively. Myelosuppression was the dose-limiting toxicity, with grade 4 neutropenia occurring in 47% of the patients and neutropenic fever in 12%. G-CSF was added in the case of grade 4 febrile neutropenia; a 25% reduction in the dose of docetaxel was required in 4 patients. Other side effects were mild.
The results of the present trial confirm the high activity of docetaxel in heavily pretreated patients with advanced breast cancer, including those with strictly defined anthracycline resistance.
更好地确定多西他赛在明确对蒽环类药物耐药的乳腺癌患者中的活性。
从1996年10月起,我们对69例接受过大量治疗的晚期乳腺癌患者进行了一项II期试验,采用多西他赛100mg/m²,于第1天静脉输注1小时,每3周重复一个周期。患者被分为原发性蒽环类药物耐药(n = 32)、继发性蒽环类药物耐药(n = 7)、接受过蒽环类药物预处理(n = 22)或未接受过蒽环类药物预处理(n = 8)。
在68例可评估患者中,我们观察到6例(9%)完全缓解和27例(40%)部分缓解,总缓解率为49%(95%置信区间37 - 61%);17例患者(25%)疾病稳定。根据上述亚组的缓解情况如下:原发性蒽环类药物耐药41%,继发性蒽环类药物耐药43%,接受过蒽环类药物预处理64%,未接受过蒽环类药物预处理43%。中位缓解时间、中位疾病进展时间和中位总生存期分别为2个月、7个月和10个月。骨髓抑制是剂量限制性毒性,47%的患者出现4级中性粒细胞减少,12%的患者出现中性粒细胞减少性发热。4级发热性中性粒细胞减少时加用粒细胞集落刺激因子;4例患者需要将多西他赛剂量降低25%。其他副作用较轻。
本试验结果证实多西他赛在接受过大量治疗的晚期乳腺癌患者中具有高活性,包括那些严格定义为对蒽环类药物耐药的患者。