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 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 12 December 2016 -- Source: Scopus |
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