Platinum-based chemotherapy in metastatic breast cancer : the Leicester (UK) experience

Decatris, M. P., Sundar, S., & O'Byrne, Kenneth J. (2005) Platinum-based chemotherapy in metastatic breast cancer : the Leicester (UK) experience. Clinical Oncology, 17(4), pp. 249-257.

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Aims: After failure of anthracycline- and taxane-based chemotherapy in metastatic breast cancer, treatment options until recently were limited. Until the introduction of capecitabine and vinorelbine, no standard regimen was available. We conducted a retrospective study to determine the efficacy and toxicity of platinum-based chemotherapy in metastatic breast cancer.

Materials and methods: Forty-two women with metastatic breast cancer previously treated with anthracyclines (93%) and/or taxanes (36%) received mitomycin-vinblastine-cisplatin (MVP) (n = 23), or cisplatin-etoposide (PE) (n = 19), as first-, second- and third-line treatment at a tertiary referral centre between 1997 and 2002. Chemotherapy was given every 3 weeks as follows: mitomycin-C (8 mg/m 2) (cycles 1, 2, 4, 6), vinblastine (6 mg/m 2), and cisplatin (50 mg/m 2) all on day 1; and cisplatin (75 mg/m 2) and etoposide (100 mg/m 2) on day 1 and (100 mg/m 2) orally twice a day on days 2-3.

Results: The response rate for 40 evaluable patients (MVP: n = 23; PE: n = 17) was 18% (95% confidence interval [CI]: 9-32%). The response rate to MVP was 13% (95% CI: 5-32%, one complete and two partial responses) and to PE 24% (10-47%, four partial responses). Disease stabilised in 43% (26-63%) and 47% (26-69%) of women treated with MVP and PE, respectively. After a median follow-up of 18 months, 37 women (MVP: n = 19; PE: n = 18) died from their disease. Median (range) progression-free survival and overall survival were 6 months (0.4-18.7) and 9.9 months (1.3-40.8), respectively. Median progression-free survival for the MVP and PE groups was 5.5 and 6.2 months (Log-rank, P = 0.82), and median overall survival was 10.2 and 9.4 months (Log-rank, P = 0.46), respectively. The main toxicity was myelosuppression. Grades 3-4 neutropenia was more common in women treated with PE than in women treated with MVP (74% vs 30%; P = 0.012), but the incidence of neutropenic sepsis, relative to the number of chemotherapy cycles, was low (7% overall). The toxicity-related hospitalisation rate was 1.2 admissions per six cycles of chemotherapy. No treatment-related deaths occurred. MVP and PE chemotherapy have modest activity and are safe in women with metastatic breast cancer. © 2005 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

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ID Code: 64968
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: Breast cancer, Chemotherapy, Metastatic, Platinum, anastrozole, anthracycline, carboplatin, cisplatin, creatinine, cyclophosphamide, etoposide, exemestane, fluorouracil, megestrol acetate, methotrexate, mitomycin C, tamoxifen, taxane derivative, vinblastine, abdominal pain, abnormal substrate concentration in blood, adult, aged, alopecia, anemia, anorexia, antineoplastic activity, article, blood transfusion, bone marrow suppression, brain hemorrhage, brain radiation, cancer adjuvant therapy, cancer combination chemotherapy, cancer growth, cancer survival, clinical article, confidence interval, controlled study, creatinine blood level, death, drug dose reduction, drug efficacy, drug fatality, drug fever, drug response, drug safety, fatigue, female, follow up, hearing loss, hospital admission, hospitalization, human, hypokalemia, hypomagnesemia, infection, kidney failure, liver toxicity, maximum permissible dose, metastasis, muscle weakness, myalgia, nausea and vomiting, neurotoxicity, neutropenia, ototoxicity, priority journal, retrospective study, sepsis, stroke, survival time, thrombocytopenia, tinnitus, United Kingdom, Anthracyclines, Antineoplastic Combined Chemotherapy Protocols, Breast Neoplasms, Great Britain, Humans, Middle Aged, Mitomycins, Neoplasm Metastasis, Retrospective Studies, Salvage Therapy, Taxoids, Treatment Outcome
DOI: 10.1016/j.clon.2005.04.001
ISSN: 0936-6555
Divisions: Current > Schools > School of Biomedical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2005 W.B. Saunders Co. Ltd.
Deposited On: 02 Dec 2013 02:28
Last Modified: 10 Jan 2014 06:25

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