A phase II study of dose-dense docetaxel and mitoxantrone in the treatment of patients with high-risk metastatic breast cancer

Doxetaxel (DCT) and mitoxantrone (MX) are highly active and potentially synergistic agents in the treatment of metastatic breast cancer (MBC). This pilot study evaluates the combination of dose-dense DCT and MX in patients with MBC to determine the efficacy and toxicity of this therapy. Thirty-six patients (56.1+/-1.7 years) were studied. The patients received DCT (35 mg/m(2) q1w) and MX (6 mg/m(2) q2w) for 6 weeks of an 8-week interval. Patients with tumor response or stable disease (SD) continued the treatment for a maximum of two additional periods. Hematologic and non-hematologic parameters were determined using the WHO common toxicity score. During this study 14 patients (40%) experienced partial response, 14 (40%) SD. In 20% of the cases the disease progressed on therapy. The treatment with DCT and MX was well tolerated. Seventeen patients (47%) experienced grade 3 leukopenia. Other hematologic and non-hematologic side effects did not exceed grade 2. One patient died during therapy because of a pulmonary embolism, which was unlikely related to active agents. Dose-dense DCT and MX combines both clinical activity and convenience for the patient. Therefore, we conclude that this regimen is a promising therapy in MBC, which warrants confirmation by large-scale clinical trials.