1
|
Kurtz JE, Rousseau F, Meyer N, Delozier T, Serin D, Nabet M, Djafari L, Dufour P. Phase II trial of pegylated liposomal doxorubicin-cyclophosphamide combination as first-line chemotherapy in older metastatic breast cancer patients. Oncology 2008; 73:210-4. [PMID: 18424884 DOI: 10.1159/000127411] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2007] [Accepted: 09/24/2007] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the efficacy and toxicity of pegylated liposomal doxorubicin (PLD; Caelyx)-cyclophosphamide combination in older metastatic breast cancer patients. METHODS A multicenter phase II trial was conducted. Inclusion criteria were age 65-75 years, ECOG 0-1 and left ventricular ejection fraction > or =50%. First-line chemotherapy was given to metastatic breast cancer patients resistant to hormonal therapy. The treatment schedule was PLD 40 mg/m(2) and cyclophosphamide 500 mg/m(2) on day 1 every 4 weeks. Efficacy was the primary endpoint, while response duration and tolerance were the secondary endpoints. RESULTS Thirty-five patients (median age 71.3 years) were enrolled. No treatment-related death, no congestive heart failure or decrease in left ventricular ejection fraction and no febrile neutropenia were reported. TOXICITY grade 3 dyspnea was found in 1 patient, neutropenia in 11 patients (7 grade 3, 4 grade 4), grade 3 mucositis in 4 patients, grade 3 hand-foot syndrome in 1 patient and a generalized rash in 1 patient. An objective response (complete and partial response) was achieved in 10 (28.6%) patients and disease control in 24 (69%) with a progression-free survival of 8.8 months and a median overall survival of 20.3 months. CONCLUSION The PLD-cyclophosphamide combination is moderately active and safe in elderly metastatic breast cancer patients, but cannot be recommended routinely due to myelotoxicity and mucositis hazards.
Collapse
Affiliation(s)
- J E Kurtz
- Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | | | | | | | | | | | | | | |
Collapse
|
2
|
Dufour PR, Rousseau F, Meyer N, Delozier T, Serin D, Nabet M, Djafari L, Kurtz J. Phase II trial of pegylated liposomal doxorubicin-cyclophosphamide combination as first-line chemotherapy in elderly metastatic breast cancer patients. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.19565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
19565 Background: Although the majority of metastatic breast cancer (MBC) patients (pts) responds to endocrine therapy, treatment failure is a concern, as well as front-line therapy for pts with ER/PR negative disease.The combination of anthracyclines (A) and cyclophosphamide (C) is active in younger pts, but cardiac toxicity of A in elderly MBC pts has to be considered. Pegylated liposomal doxorubicin (PLD) (Caelyx®) is active in MBC and has much less cardiotoxicity than A, and we present the preliminary data of the PLD/C in elderly MBC pts. Methods: This was a multicentric phase II trial. Inclusion criteria included: pts aged between 65 and 75, histologically proven measurable MBC, ECOG PS 0–1, LVEF = 50%, first-line chemotherapy for MBC. Prior adjuvant chemotherapy was allowed if stopped for = 6 or 12 months without and with anthracyclines, respectively. Endocrine therapy either in the adjuvant or metastatic setting had to be stopped for = 1 month. All pts gave a written informed consent. The treatment schedule was : PLD 40mg/m2 and C 500mg/m2 d1 every 4 weeks. Efficacy as well as response duration and tolerance were the primary and secondary end-points, respectively. Results: 35 patients were enrolled (Median age 71.3, range 65.6–75.9). A total of 166 cycles have been administered. The median number of cycles was 6 (range 1–9). No toxic death was reported, one patient died of diabetes mellitus decompensation. No congestive heart failure or decrease in LVEF was reported, although 1 pt experience grade 3 dyspnea and stopped treatment. Other (gr3–4) NCI-CTC toxicity included: neutropenia in 7 (gr3) and 3 (gr4) pts; gr3 mucositis (4). No febrile neutropenia was reported. Grade 3 hand-foot syndrome occurred in 1 pt, whereas treatment was stopped due to a generalized rash in 1 pt. An objective response (CR + PR) was achieved in 10 (28,6%) pts (1 CR and 8 PR), and a disease control in 24 (68.6%) with a progression free survival of 8.8 months and a median survival of 20.4 months Conclusions: The LPD-C combination is active in elderly MBC pts, with an acceptable toxicity profile. No significant financial relationships to disclose.
Collapse
Affiliation(s)
- P. R. Dufour
- Centre Paul Strauss, Strasbourg, France; Institut Paoli-Calmettes,, Marseille, France; Hôpitaux Universitaires de Strasbourg,, Strasbourg, France; Centre Francois Baclesse, Caen, France; Clinique St. Catherine, Avignon, France; Clinique Claude Bernard, Metz, France; Schering-Plough, Levallois-Perret, France; Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - F. Rousseau
- Centre Paul Strauss, Strasbourg, France; Institut Paoli-Calmettes,, Marseille, France; Hôpitaux Universitaires de Strasbourg,, Strasbourg, France; Centre Francois Baclesse, Caen, France; Clinique St. Catherine, Avignon, France; Clinique Claude Bernard, Metz, France; Schering-Plough, Levallois-Perret, France; Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - N. Meyer
- Centre Paul Strauss, Strasbourg, France; Institut Paoli-Calmettes,, Marseille, France; Hôpitaux Universitaires de Strasbourg,, Strasbourg, France; Centre Francois Baclesse, Caen, France; Clinique St. Catherine, Avignon, France; Clinique Claude Bernard, Metz, France; Schering-Plough, Levallois-Perret, France; Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - T. Delozier
- Centre Paul Strauss, Strasbourg, France; Institut Paoli-Calmettes,, Marseille, France; Hôpitaux Universitaires de Strasbourg,, Strasbourg, France; Centre Francois Baclesse, Caen, France; Clinique St. Catherine, Avignon, France; Clinique Claude Bernard, Metz, France; Schering-Plough, Levallois-Perret, France; Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - D. Serin
- Centre Paul Strauss, Strasbourg, France; Institut Paoli-Calmettes,, Marseille, France; Hôpitaux Universitaires de Strasbourg,, Strasbourg, France; Centre Francois Baclesse, Caen, France; Clinique St. Catherine, Avignon, France; Clinique Claude Bernard, Metz, France; Schering-Plough, Levallois-Perret, France; Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - M. Nabet
- Centre Paul Strauss, Strasbourg, France; Institut Paoli-Calmettes,, Marseille, France; Hôpitaux Universitaires de Strasbourg,, Strasbourg, France; Centre Francois Baclesse, Caen, France; Clinique St. Catherine, Avignon, France; Clinique Claude Bernard, Metz, France; Schering-Plough, Levallois-Perret, France; Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - L. Djafari
- Centre Paul Strauss, Strasbourg, France; Institut Paoli-Calmettes,, Marseille, France; Hôpitaux Universitaires de Strasbourg,, Strasbourg, France; Centre Francois Baclesse, Caen, France; Clinique St. Catherine, Avignon, France; Clinique Claude Bernard, Metz, France; Schering-Plough, Levallois-Perret, France; Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - J. Kurtz
- Centre Paul Strauss, Strasbourg, France; Institut Paoli-Calmettes,, Marseille, France; Hôpitaux Universitaires de Strasbourg,, Strasbourg, France; Centre Francois Baclesse, Caen, France; Clinique St. Catherine, Avignon, France; Clinique Claude Bernard, Metz, France; Schering-Plough, Levallois-Perret, France; Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| |
Collapse
|