Seidman A D
Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Oncology (Williston Park). 1998 Jan;12(1 Suppl 1):19-22.
A preliminary report of phase II trial of paclitaxel (Taxol) administered in a dose-dense manner as first- and second-line therapy for metastatic breast cancer is presented. Patients who had received one or two prior chemotherapy regimens for metastatic disease or in the adjuvant setting were eligible. Prior treatment with an anthracycline was permitted, but patients who had previously received taxanes were excluded. Initial dose was paclitaxel 100 mg/m2 infused over 1 hour weekly until disease progression or intolerable toxicity. To date, significant activity and a highly favorable toxicity profile have been observed with 1-hour paclitaxel < or = 100 mg/m2. Less myelosuppression occurred than would have been expected with a standard regimen (paclitaxel 175 mg/m2 given over 3 hours q3wks). Neurotoxicity became dose limiting at paclitaxel > 100 mg/m2/wk. The apparent safety and high therapeutic index of paclitaxel administered in a dose-dense fashion increases therapeutic options for patients with breast cancer, and further studies are warranted.
本文呈现了一项关于紫杉醇（泰素）以密集剂量方式作为转移性乳腺癌一线和二线治疗的II期试验的初步报告。接受过一或两种先前针对转移性疾病或辅助治疗的化疗方案的患者符合条件。允许先前使用过蒽环类药物进行治疗，但先前接受过紫杉烷类药物治疗的患者被排除。初始剂量为紫杉醇100mg/m²，每周静脉输注1小时，直至疾病进展或出现无法耐受的毒性。迄今为止，对于1小时输注紫杉醇≤100mg/m²，已观察到显著的活性和非常良好的毒性特征。与标准方案（每3周一次，3小时内给予紫杉醇175mg/m²）相比，骨髓抑制发生率更低。当紫杉醇剂量>100mg/m²/周时，神经毒性成为剂量限制性毒性。以密集剂量方式给药的紫杉醇明显的安全性和高治疗指数增加了乳腺癌患者的治疗选择，因此有必要进行进一步研究。
