Alan Keller1, Robert Mennel1, Vassilis A. Georgoulias1, Jean-Marc Nabholtz1, Aura Erazo1, Aña Lluch1, Charles L. Vogel1, Manfred Kaufmann1, Gunther von Minckwitz1, I. Craig Henderson1, L. Mellars1, Leila Alland1, Craig Tendler1
1From US Oncology Inc, Cancer Care Associates, Tulsa, OK; US Oncology, Dallas, TX; University Hospital of Heraklion, Heraklion, Crete, Greece; Cross Cancer Institute, Edmonton, Alberta, Canada; Centro Medico Nacional ISSSTE, Mexico, D.F. Mexico; Hospital Clinico Universitario, Valencia, Spain; Aventura Concorde Center II, Aventura, FL; Department of Gynecology and Obstetrics, Johann Wolfgang Goethe-University, Frankfurt, Germany; University of California San Francisco, San Francisco, CA; Schering-Plough...
Tóm tắt
Purpose To compare the efficacy of pegylated liposomal doxorubicin (PLD) with that of a common salvage regimen (comparator) in patients with taxane-refractory advanced breast cancer. Patients and Methods Following failure of a first- or second-line taxane-containing regimen for metastatic disease, 301 women were randomly assigned to receive PLD (50 mg/m2 every 28 days); or comparator-vinorelbine (30 mg/m2 weekly) or mitomycin C (10 mg/m2 day 1 and every 28 days) plus vinblastine (5 mg/m2 day 1, day 14, day 28, and day 42) every 6 to 8 weeks. Patients were stratified before random assignment based on number of previous chemotherapy regimens for metastatic disease and presence of bone metastases only. Results Progression-free survival (PFS) and overall survival (OS) were similar for PLD and comparator (PFS: hazard ratio [HR], 1.26; 95% CI, 0.98 to 1.62; P = .11; median, 2.9 months [PLD] and 2.5 months [comparator]; OS: HR, 1.05; 95% CI, 0.82 to 1.33; P = .71; median, 11.0 months [PLD] and 9.0 months [comparator]). In anthracycline-naïve patients, PFS was somewhat longer with PLD, relative to the comparator (n = 44; median PFS, 5.8 v 2.1 months; HR, 2.40; 95% CI, 1.16 to 4.95; P = .01). Most frequently reported adverse events were nausea (23% to 31%), vomiting (17% to 20%), and fatigue (9% to 20%) and were similar among treatment groups. PLD-treated patients experienced more palmar-plantar erythrodysesthesia (37%; 18% grade 3, 1 patient grade 4) and stomatitis (22%; 5% grades 3/4). Neuropathy (11%), constipation (16%), and neutropenia (14%) were more common with vinorelbine. Alopecia was low in both the PLD and vinorelbine groups (3% and 5%). Conclusion PLD has efficacy comparable to that of common salvage regimens in patients with taxane-refractory metastatic breast cancer, thereby representing a useful therapeutic option.
