Published in:
01-08-2010 | Original Article
Paclitaxel combined with ifosfamide in anthracycline- and docetaxel-pretreated metastatic breast cancer: activity independence of prior docetaxel resistance
Authors:
Yong Wha Moon, Joo Hyuk Sohn, Hye Jin Choi, Hyun Chang, Byeong-Woo Park, Seung Il Kim, Seho Park, Ja Seung Koo, Yong Tai Kim, Jae Kyung Roh, Hyun Cheol Chung, Joo-Hang Kim
Published in:
Cancer Chemotherapy and Pharmacology
|
Issue 3/2010
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Abstract
Background
We evaluated the efficacy and tolerability of combined paclitaxel and ifosfamide in anthracycline- and docetaxel-pretreated metastatic breast cancer (MBC).
Methods
Patients received paclitaxel (175 mg/m2 i.v. in a 3-h infusion) on day 1 and ifosfamide (1.5 g/m2 i.v. in a 15-min infusion) on days 1–3, every 3 weeks for a maximum of nine cycles. The tumor response was assessed every two cycles.
Results
We enrolled 34 patients with a median age of 50 years. Thirty patients had visceral metastases. Anthracycline- and docetaxel-based chemotherapy had previously been administered to 18/13 and 13/21 patients, respectively, in (neo)adjuvant/metastatic settings. Three patients had not previously received anthracycline due to abnormal cardiac functions. A total of 174 cycles of chemotherapy were delivered with a median of six cycles. The response rate under the intent-to-treat analysis was 23.5% (all partial responses) with a median response duration of 14 months. The disease control rate was 70.6%. The median progression-free and overall survival were 5.9 and 8.5 months, respectively. There was no apparent relationship between activity and prior docetaxel resistance. The incidence of grade III/IV neutropenia was 46.6% (81 of 174 cycles) with febrile neutropenia of only 1.7%. Major grade III/IV non-hematological toxicities included peripheral neuropathy (6 of 34 patients) and infection (4 of 34 patients). There were no treatment-related deaths.
Conclusion
Paclitaxel combined with ifosfamide was effective and tolerable in anthracycline-/docetaxel-pretreated MBC. Overcoming docetaxel resistance by using paclitaxel in combination with ifosfamide needs to be addressed through further investigation.