First-line paclitaxel and cisplatin used sequentially or in combination in metastatic breast cancer: A phase II randomized study.
J Egypt Natl Canc Inst
; 30(1): 13-20, 2018 Mar.
Article
em En
| MEDLINE
| ID: mdl-29428373
ABSTRACT
INTRODUCTION:
Breast cancer (BC) is the commonest cancer among females worldwide. Some patients present initially at advanced stages and more than 50% of them will develop metastasis (MBC) at some point. Compared to single agents, combination chemotherapy produces higher response rates (RR), longer progression-free survival (PFS) than single agents. This is associated with remarkably higher toxicities. At the same time, overall survival (OS) is comparable. This study aimed to compare safety and efficacy of combination and sequential chemotherapy. PATIENTS ANDMETHODS:
Forty-six MBC patients were randomized to receive 6 cycles of the combination of paclitaxel (175â¯mg/m2) and cisplatin (70â¯mg/m2) (combination PC) or paclitaxel for 3 cycles followed by cisplatin for 3 cycles (sequential PC). Endpoints were RR, PFS, OS and safety.RESULTS:
Both combination and sequential PC produced similar RR (52% in both arms) and disease control rates (78.3% vs. 73.9%, pâ¯=â¯.652). Responses were faster in the combination arm. Median PFS was 8.2â¯months in the combination compared to 5.0â¯months in the sequential arm (pâ¯=â¯.064). The median OS was 16.5 and 18.8â¯months in the combination and sequential arms, respectively (pâ¯=â¯.866). The combination was more toxic than sequential PC. Grade 3 toxicities were higher with combination PC than to sequential PC (48% vs. 4.3%; pâ¯<â¯.001).CONCLUSION:
Sequential agent chemotherapy may provide similar response rate and overall survival to combination chemotherapy with much lower toxicities. The former can be considered the standard practice in most instances.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias da Mama
/
Protocolos de Quimioterapia Combinada Antineoplásica
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Cisplatino
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Paclitaxel
Tipo de estudo:
Clinical_trials
Limite:
Adult
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Female
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Humans
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Middle aged
Idioma:
En
Revista:
J Egypt Natl Canc Inst
Assunto da revista:
NEOPLASIAS
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Egito