Scheithauer W, Kornek G, Haider K, Kwasny W, Schenk T, Pirker R, Depisch D
Department of Internal Medicine I, Vienna University Medical School, Austria.
Breast Cancer Res Treat. 1993;26(1):49-53. doi: 10.1007/BF00682699.
The efficacy and toxicity of navelbine 30 mg/m2 administered intravenously (IV) over 30 minutes every 3 weeks, and mitomycin C 15 mg/m2 administered IV every 6 weeks was assessed in 34 patients with metastatic breast cancer refractory to first-line chemotherapy. An overall objective response rate of 35% was achieved (95% confidence interval, 20% to 53%), with an additional 47% of patients maintaining stable disease (SD). Four of 12 patients who responded had received previous anthracycline therapy. Median time to progression for responders and patients with SD was 6.3 months. The median survival of all patients was 8.8 months. Tolerance of this regimen was remarkable. WHO grade 3/4 side effects consisted of granulocytopenia in 12% and thrombocytopenia in 15%, and included only 1 patient each with grade 3 neurotoxicity and local toxicity due to extravasation. Delay of treatment was required for hematologic toxicity in 7 patients, and 5 required dose reductions. In conclusion, navelbine/mitomycin C is an active and well-tolerated regimen that may be considered for second-line treatment. If our results are confirmed by larger analyses of other patients studies, this combination might also warrant further exploration in combination with other active agents for front line chemotherapy of advanced breast cancer.
对34例一线化疗难治的转移性乳腺癌患者,评估了每3周静脉注射(IV)30分钟给予长春瑞滨30mg/m²,以及每6周静脉注射丝裂霉素C 15mg/m²的疗效和毒性。总体客观缓解率为35%(95%置信区间,20%至53%),另有47%的患者病情稳定(SD)。12例有反应的患者中有4例曾接受过蒽环类药物治疗。有反应者和病情稳定患者的中位进展时间为6.3个月。所有患者的中位生存期为8.8个月。该方案的耐受性良好。世界卫生组织3/4级副作用包括12%的粒细胞减少和15%的血小板减少,仅各有1例患者出现3级神经毒性和因外渗导致的局部毒性。7例患者因血液学毒性需要延迟治疗,5例需要降低剂量。总之,长春瑞滨/丝裂霉素C是一种有效的且耐受性良好的方案,可考虑用于二线治疗。如果我们的结果能被其他患者研究的更大规模分析所证实,这种联合方案也可能值得进一步探索与其他活性药物联合用于晚期乳腺癌的一线化疗。