Literature DB >> 20859353

Phase II Trial of a Novel Paclitaxel Schedule As Single-Agent, First-Line Therapy for HER-2/neu-Negative Metastatic Breast Cancer: A Community-Based Study.

David Loesch1, Nicholas Robert, Stephen Jones, Maha Elkordy, Des Ilegbodu, Lina Asmar.   

Abstract

PURPOSE: To determine the response rate (RR), progression-free survival (PFS), and toxicity in patients with HER-2/neu-negative metastatic breast cancer treated with first-line paclitaxel in a de-escalating dosing schedule. PATIENTS AND METHODS: Between August 1999 and December 2000, 73 patients were enrolled. Paclitaxel was administered on day 1 (175 mg/m(2)) and on days 8 and 15 (80 mg/m(2) each) in each 4-week cycle (1 week of rest). Doses were de-escalated with the aim of reducing toxicity. An Eastern Cooperative Oncology Group performance status of 0, 1, or 2 was found in 55%, 41%, and 4% of patients, respectively. Median age was 59 years (range, 38 to 84 years), and 86% of patients had received prior surgery; 60%, adjuvant chemotherapy; and 59%, radiation therapy.
RESULTS: Based on an intention-to-treat analysis (N = 73), there were five patients with a complete response (6.8%), 16 with a partial response (21.9%), 17 with stable disease (23.3%), and 23 with progressive disease (31.5%) for an RR of 28.7%. Twelve patients (16.4%) were not assessable for response due to toxicity (seven patients, mainly neuropathy), withdrawal of consent (two patients), early death (two patients), or noncompliance (one patient). Median PFS was 6.5 months (range, < 1 to 36.1 months), median survival was 22.8 months (range, < 1 to 36.1 months), and median duration of response was 8.8 months (range, 3.0 to 31.8 months). Patients (n = 72) were evaluated for toxicity. Grade 3 to 4 treatment-related toxicities occurring in more than 5% of patients included neutropenia (22.2%), neuropathy (18.1%), fatigue (6.9%), and leukopenia (5.6%).
CONCLUSION: In a unique de-escalating schedule, this study of single-agent paclitaxel produced a response rate similar to other single-agent paclitaxel schedules, in first-line therapy for metastatic breast cancer, published in the literature. However, this schedule is not recommended for the therapy of metastatic breast cancer because of the higher rate of toxicity.

Entities:  

Year:  2006        PMID: 20859353      PMCID: PMC2793644          DOI: 10.1200/JOP.2006.2.6.268

Source DB:  PubMed          Journal:  J Oncol Pract        ISSN: 1554-7477            Impact factor:   3.840


  18 in total

1.  Prognostic factors for survival in metastatic breast cancer during first-line paclitaxel chemotherapy.

Authors:  Benjamin Nisman; Vivian Barak; Ayala Hubert; Luna Kaduri; Olga Lyass; Mario Baras; Tamar Peretz
Journal:  Anticancer Res       Date:  2003 Mar-Apr       Impact factor: 2.480

Review 2.  Chemotherapy of breast cancer: are the taxanes going to change the natural history of breast cancer?

Authors:  J M Nabholtz; K Tonkin; M Smylie; H J Au; M A Lindsay; J Mackey
Journal:  Expert Opin Pharmacother       Date:  2000-01       Impact factor: 3.889

3.  Assessment of response and recurrence in breast cancer.

Authors:  J L Hayward; J W Meakin; H J Stewart
Journal:  Semin Oncol       Date:  1978-12       Impact factor: 4.929

4.  [Two cases of effective weekly paclitaxel administration for metastatic breast cancer].

Authors:  I Kokufu; H Taniguchi; Y Kim; K Fukuda; M Yamamoto; T Yano; K Yamada; H Kitano
Journal:  Gan To Kagaku Ryoho       Date:  2001-11

5.  Single-agent paclitaxel as first-line treatment of metastatic breast cancer: the British experience.

Authors:  N G Davidson
Journal:  Semin Oncol       Date:  1996-10       Impact factor: 4.929

6.  Randomized trial of 3-hour versus 24-hour infusion of high-dose paclitaxel in patients with metastatic or locally advanced breast cancer: National Surgical Adjuvant Breast and Bowel Project Protocol B-26.

Authors:  R E Smith; A M Brown; E P Mamounas; S J Anderson; B C Lembersky; J H Atkins; H R Shibata; L Baez; P A DeFusco; E Davila; S J Tipping; J D Bearden; M P Thirlwell
Journal:  J Clin Oncol       Date:  1999-11       Impact factor: 44.544

7.  Monotherapy with paclitaxel as third-line chemotherapy against anthracycline-pretreated and docetaxel-refractory metastatic breast cancer.

Authors:  Jun Kinoshita; Shunsuke Haga; Tadao Shimizu; Hiroshi Imamura; Osamu Watanabe; Hiroshi Nagumo; Yoshihito Utada; Toshihiko Okabe; Kiyomi Kimura; Akira Hirano; Tetsuro Kajiwara
Journal:  Breast Cancer       Date:  2002       Impact factor: 4.239

8.  Metastatic breast cancer with resistance to both anthracycline and docetaxel successfully treated with weekly paclitaxel.

Authors:  M Ishitobi; E Shin; N Kikkawa
Journal:  Int J Clin Oncol       Date:  2001-02       Impact factor: 3.402

9.  Multicenter phase II trial of weekly paclitaxel for advanced or metastatic breast cancer: the Saitama Breast Cancer Clinical Study Group (SBCCSG-01).

Authors:  Kazuhiko Sato; Kenichi Inoue; Tsuyoshi Saito; Toshihiro Kai; Hiroyoshi Mihara; Katsuhiko Okubo; Junichi Koh; Hidetaka Mochizuki; Toshio Tabei
Journal:  Jpn J Clin Oncol       Date:  2003-08       Impact factor: 3.019

10.  Weekly paclitaxel in metastatic breast cancer patients: a phase II study.

Authors:  Stefania Gori; Anna Maria Mosconi; Carlo Basurtol; Roberta Cherubinil; Verena De Angelis; Maurizio Tonato; Mariantonietta Colozza
Journal:  Tumori       Date:  2002 Nov-Dec
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