The impact of schedule on acute toxicity and dose-intensity of high-dose chemotherapy with epirubicin and cyclophosphamide plus colony stimulating factors in advanced breast cancer
| العنوان: | The impact of schedule on acute toxicity and dose-intensity of high-dose chemotherapy with epirubicin and cyclophosphamide plus colony stimulating factors in advanced breast cancer |
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| المؤلفون: | A Martignetti, F. Perrone, Ciro Gallo, Chiara Carlomagno, G. Petrella, Angelo Raffaele Bianco, Gennaro Limite, Teresa Bellelli, Rossella Lauria, M. De Laurentiis, S. De Placido |
| المساهمون: | DE PLACIDO, S, Lauria, R, Carlomagno, C, Perrone, F, DE LAURENTIIS, M, Gallo, Ciro, Martignetti, A, Bellelli, T, Limite, G, Petrella, G, Bianco, Ar, DE PLACIDO, Sabino, Lauria, Rossella, Carlomagno, Chiara, F., Perrone, DE LAURENTIIS, Michelino, C., Gallo, A., Martignetti, T., Bellelli, Limite, Gennaro, Petrella, Giuseppe, Bianco, ANGELO RAFFAELE |
| المصدر: | Scopus-Elsevier |
| بيانات النشر: | Spandidos Publications, 1999. |
| سنة النشر: | 1999 |
| مصطلحات موضوعية: | Cancer Research, medicine.medical_specialty, Cyclophosphamide, medicine.medical_treatment, Breast Neoplasms, Gastroenterology, Drug Administration Schedule, chemistry.chemical_compound, Breast cancer, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, Granulocyte Colony-Stimulating Factor, medicine, Mucositis, Humans, Survival rate, Aged, Epirubicin, Neoplasm Staging, Chemotherapy, Dose-Response Relationship, Drug, business.industry, Granulocyte-Macrophage Colony-Stimulating Factor, toxicity, medicine.disease, Hematologic Diseases, Metastatic breast cancer, Nitrogen mustard, Surgery, Survival Rate, Treatment Outcome, Oncology, chemistry, Feasibility Studies, Female, metastatic breast cancer, business, high-dose chemotherapy, medicine.drug |
| الوصف: | To increase the dose-intensity of two drugs in metastatic breast cancer, we tested the feasibility, in phase I studies, of two schedules of epirubicin (E) and cyclophosphamide (C) - sequential (E--> C) and alternating (E/C) - with respect to the standard combination (EC). Drugs were given at three planned-dose levels, plus either G-CSF or GM-CSF. Patients with metastatic (30), inoperable stage IIIb (2) or inflammatory (7) breast cancer were treated. The doses of EC, given every 21 days (4 cycles), were 75/1500, 82.5/2250, 90/3000 mg/m2. In the E/C schedule, epirubicin was given at cycles 1, 3 and 5, and cyclophosphamide at cycles 2, 4 and 6. In the E--> C schedule, three cycles of epirubicin then three cycles of cyclophosphamide were administered. In both experimental schedules, drugs were given every 14 days for 6 cycles at doses of 100, 110, 120 mg/m2 (E) and 2000, 3000, 4000 mg/m2 (C). The average relative dose-intensity was 1.2-fold and 2-fold greater with E/C and E--> C, respectively, than with EC. The third level dose was feasible with all schedules. Grade 4 leucopenia occurred in 77\% of patients. Thrombocytopenia was absent in 6 cases and grade 4 in 12 (30.8\%). Eighty-one percent of patients on experimental schedules required red blood cell support versus 44.4\% of patients on EC. At the third level, platelet transfusions were more frequent among patients treated with EC (27. 8\%). Non-haematological toxicity was mild: about 20\% of patients experienced grade 3 vomiting, irrespective of schedule. Only 2 patients had grade 3 mucositis; no patient developed heart failure. Fever (61\% of patients) and bone pain (55.5\% of patients) were relevant in the GM-CSF treated groups and 12 patients shifted to G-CSF. The overall response rate was 84.6\%: 5/39 (12.8\%) complete response and 28/39 (71.8\%) partial response. At 30/9/98, median survival was 29.5 months, with no difference between patients with metastatic and stage IIIb/inflammatory breast cancer. Median follow-up of surviving patients was 62 months (range 17-83). The 5-year estimated survival was 19\% (95\% confidence intervals = 7-31\%). Rapidly alternating or sequential cycles of epirubicin and cyclophosphamide with CSF support is a feasible strategy that allows a higher increase of dose-intensity of the single drugs. Hospitalization and anemia were more frequent with the experimental schedules, and thrombocytopenia with the standard schedule. Overall, this intensified therapy was very active. |
| وصف الملف: | STAMPA |
| تدمد: | 1791-2423 1019-6439 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2ec76c66ea388e58213c4e8fa864962cTest https://doi.org/10.3892/ijo.15.2.339Test |
| حقوق: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....2ec76c66ea388e58213c4e8fa864962c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17912423 10196439 |
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