Vinorelbine and cisplatin in metastatic breast cancer patients previously treated with anthracyclines

Citation
M. Vassilomanolakis et al., Vinorelbine and cisplatin in metastatic breast cancer patients previously treated with anthracyclines, ANN ONCOL, 11(9), 2000, pp. 1155-1160
Citations number
42
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Oncology,"Onconogenesis & Cancer Research
Journal title
ANNALS OF ONCOLOGY
ISSN journal
0923-7534 → ACNP
Volume
11
Issue
9
Year of publication
2000
Pages
1155 - 1160
Database
ISI
SICI code
0923-7534(200009)11:9<1155:VACIMB>2.0.ZU;2-F
Abstract
Purpose: To assess the antitumor efficacy and safety of a vinorelbine and c isplatin combination in patients with metastatic breast cancer previously t reated with anthracyclines. Patients and methods: Fifty-three patients with assessable metastatic breas t cancer with previous exposure to anthracyclines (adjuvant n = 6, palliati ve n = 47) were studied. Cisplatin 75 mg/m(2) on day 1 was given followed b y 25 mg/m(2) vinorelbine (VNR) on days 1 + 8, in a five-min i.v. infusion. Courses were repeated every three weeks on an outpatient basis. Treatment c ontinued until disease progression, excess toxicity or patient refusal. Pat ients were classified according to their response to anthracyclines: anthra cycline refractory patients were patients who had never responded under an anthracycline regimen. Anthracycline resistant patients were either metasta tic patients who progressed within four months of completing anthracycline- based chemotherapy or patients who progressed within six months of completi on of an anthracycline adjuvant treatment. Patients who progressed four mon ths after the end of an anthracycline regimen in metastatic setting or six months after the end of an anthracycline regimen in adjuvant setting were c onsidered as patients previously treated with anthracyclines and were calle d 'relapsed'. Results: Four patients (8%) achieved a complete response (CR) and twenty-tw o patients (41%) achieved a partial response (PR) with an overall response rate (OR) of 49% (95% confidence interval (CI): 35-63). Stable disease (SD) was observed in five patients (9%), twenty-two patients had progressive di sease (PD). Responses according to previous sensitivity to anthracycline we re as follow: 5 refractory patients achieved a PR from 14 patients (36%). S even of sixteen resistant patients responded (44%), six with PR and one wit h CR. Among 23 'relapsed' patients, 14 responses were observed (61%), with 3 CR and 11 PR. There was no statistical difference in RR among the three g roups. The median duration of response for all patients was 7 months, the m edian time to progression (TTP) 5 months and median overall survival 12 mon ths. All patients were assessed for toxicity. The main toxicity was neutropenia grade 3 and 4 in 49% of patients. Febrile neutropenia requiring hospitaliza tion was uncommon (2 patients). There were no treatment related deaths. Des pite potential overlapping neurologic toxicities of the two drugs, only eig ht patients (15%) developed neuropathy, which was, however, mild (grades 1 and 2). Conclusions: This cisplatin-VNR regimen is well tolerated and active in pat ients who failed anthracyclines. The response rate, TTP and survival data a re engouranging and indicate that cisplatin-VNR may have a place as second- line treatment alternative to taxanes or other less active regimens. If the se results can be verified in multi-institution trials, this combination of drugs would merit investigation as first-line therapy in this patient popu lation.