High-dose sequential epirubicin and cyclophosphamide with peripheral blood stem cell support for advanced breast cancer: results of a phase II study
| Autor: | J M Miclea, D Mayeur, Valérie Laurence, Caroline Cuvier, PH Cottu, Marc Espié, J.M. Extra, A de Roquancourt, Jean-Pierre Marolleau, Michel Marty, J Makke, Florence Lerebours |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Neutropenia Fever Cyclophosphamide Injections Subcutaneous medicine.medical_treatment Breast Neoplasms Hematopoietic stem cell transplantation chemotherapy Gastroenterology Disease-Free Survival Drug Administration Schedule breast cancer Breast cancer Internal medicine Antineoplastic Combined Chemotherapy Protocols Granulocyte Colony-Stimulating Factor medicine Humans Infusions Intravenous Epirubicin high-dose Chemotherapy Dose-Response Relationship Drug business.industry Hematopoietic Stem Cell Transplantation Regular Article Middle Aged medicine.disease Surgery Regimen Treatment Outcome advanced Oncology Female business Febrile neutropenia medicine.drug |
| Zdroj: | British Journal of Cancer |
| ISSN: | 1532-1827 0007-0920 |
| DOI: | 10.1054/bjoc.2001.2069 |
| Popis: | The aim of this study was to evaluate the feasibility of a high-dose intensity and high-dose density multicycle epirubicin and cyclophosphamide regimen with peripheral blood stem cells (PBSC) and haematopoietic growth factor (G-CSF) support in advanced breast cancer patients. From August 1994 to September 1999, 56 breast cancer patients (8 stage IIIB and 48 stage IV) received 205 courses of cyclophosphamide 3 g x m(-2) and epirubicin 100 mg x m(-2) every 14 days. G-CSF 5 microg x kg(-1) x day(-1) was administered from day 3 to neutrophil recovery. 4 courses were planned. PBSC were collected after course 1, and reinfused after courses 3 and 4, withor = 2 x 10(6) CD34+ PBSC x kg(-1) required for each reinfusion. 48 patients (86%) received all 4 planned courses. Early withdrawal was consecutive to infectious complications (n = 4), severe asthenia (n = 3), haemorrhagic cystitis (n = 1). A median number of 10.8 x 10(6) CD34+ PBSC x kg(-1) (range, 3-80) was harvested with 1 or 2 apheresis in 48 patients (94%). Median relative dose intensity was 91.3% (range, 72-102%). Grade 4 neutrophil toxicity was observed in 100% of patients. Febrile neutropenia was observed in 40% of courses (median duration 2 days). Red blood cells and platelets had to be transfused in 54% and 27% of courses, respectively. There were no toxic deaths. Objective response rate was 69% in stage IV patients (31/45 evaluable pts), with a 16% complete response rate. Their median progression-free and overall survivals were 22.5 and 37 months, respectively. This epirubicine-containing high-dose regimen appeared feasible, albeit with high toxicity. Time-related progression parameters exceed commonly reported ones. Controlled studies of upfront sequential high-dose chemotherapy are still needed to evaluate its real benefit. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|