Dose-dense therapy with weekly 1-hour paclitaxel infusions in the treatment of metastatic breast cancer Journal Article

Authors: Seidman, A. D.; Hudis, C. A.; Albanel, J.; Tong, W.; Tepler, I.; Currie, V.; Moynahan, M. E.; Theodoulou, M.; Gollub, M.; Baselga, J.; Norton, L.
Article Title: Dose-dense therapy with weekly 1-hour paclitaxel infusions in the treatment of metastatic breast cancer
Abstract: Purpose: To evaluate the efficacy and toxicity of paclitaxel administered as a 1 -hour infusion on weekly basis, without interruption, to patients with metastatic breast cancer who had received prior therapy. Patients and Methods: Thirty patients with metastatic breast cancer received sustained weekly paclitaxel therapy at an initial dose of 100 mg/m2 until disease progression. Prior therapy included adjuvant only (n = 17), metastatic only (n = 7), or both (n = 6). Eighteen patients had received prior anthracycline therapy, 12 of whom had demonstrated progression of disease within 12 months of it. All patients were assessable for efficacy; 29 patients were assessable far toxicity. Pharmacokinetic studies of paclitaxel were also performed. Results: A total of 469 weekly paclitaxel infusions were administered to 30 patients (median, 14 infusions/patient). The median delivered dose-intensity was 91 mg/m2/wk (range, 80 to 108). The overall response rate was 53% (95% confidence interval [Cl], 34% to 72%), with 10% complete responses (CRs) and 43% partial responses (PRs). Median response duration was 7.5 months (range, 2 to 11+). Responses were observed in nine of 18 (50%) patients with prior anthracycline therapy, including six of 12 (50%) with disease progression on anthracycline within 1 year (three of four within 6 months). Therapy was well tolerated and remarkable for a lack of overall and cumulative myelosuppression. Grade 3/4 neutropenia occurred in four patients; febrile neutropenia was not observed. Peripheral neuropathy prohibited dose escalation above 100 mg/m2, and grade 3 neuropathy was observed in two of 21 patients at ≤ 100 mg/m2. Conclusion: Weekly paclitaxel therapy is active and well tolerated in patients with metastatic breast cancer. Weekly therapy should be considered as a current clinical option for these patients and should be incorporated into future comparative clinical trials.
Keywords: adult; cancer chemotherapy; clinical article; treatment outcome; aged; middle aged; disease course; drug tolerability; neutropenia; drug efficacy; paclitaxel; cancer grading; breast cancer; neuropathy; drug administration schedule; antineoplastic agents, phytogenic; dexamethasone; breast neoplasms; drug response; anthracycline; infusions, intravenous; intravenous drug administration; oral drug administration; diphenhydramine; cimetidine; humans; human; female; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 16
Issue: 10
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 1998-10-01
Start Page: 3353
End Page: 3361
Language: English
PUBMED: 9779712
PROVIDER: scopus
DOI: 10.1200/JCO.1998.16.10.3353
Notes: Article -- Export Date: 12 December 2016 -- Source: Scopus
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MSK Authors
  1. William Ping-Yiu Tong
    122 Tong
  2. Andrew D Seidman
    244 Seidman
  3. Clifford Hudis
    840 Hudis
  4. Larry Norton
    562 Norton
  5. Marc J Gollub
    105 Gollub
  6. Violante Currie
    30 Currie
  7. Jose T Baselga
    395 Baselga