Phase I study of Doxil and vinorelbine in metastatic breast cancer |
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Authors: | H. J. Burstein M. J. Ramirez W. P. Petros K. D. Clarke M. A. Warmuth P. K. Marcom U. A. Matulonis L. M. Parker L. N. Harris E. P. Winer |
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Affiliation: | (1) Department of Adult Oncology, Dana-Farber Cancer Institute, Department of Medicine, Brigham and Women';s Hospital, Harvard Medical School, Boston, USA;(2) Hematology/Oncology Division, Duke University Medical Center, Durham, NC, USA |
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Abstract: | Background: Vinorelbine and Doxil (liposomal doxorubicin) are active chemotherapeutic agents in metastatic breast cancer. A phase I study was designed to evaluate combination therapy.Patients and methods: Thirty women with metastatic breast cancer were enrolled. Dose-limiting toxicity was determined through a dose escalation scheme, and defined for the first treatment cycle, only. Pharmacokinetic studies were performed during the first cycle of treatment.Results: In the first cohort of Doxil 30 mg/m2 day 1 and vinorelbine 25 mg/m2 days 1 and 8, patients experienced severe neutropenia. Vinorelbine administration was changed thereafter to days 1 and 15 of each cycle. Dose limiting toxicity was observed at Doxil 50 mg/m2 and vinorelbine 25 mg/m2. Doxil 40 mg/m2 and vinorelbine 30 mg/m2 was defined as the maximally tolerated dose. Few toxicities (principally neutropenia) were seen at this dose level, with the notable absence of significant nausea, vomiting, or alopecia. Though 63% of patients had received prior anthracycline-based chemotherapy, only one patient developed grade 2 cardiac toxicity. Pharmacokinetic studies revealed prolonged exposure to high doxorubicin concentrations for several days following Doxil administration.Conclusions: Combination chemotherapy with Doxil and vinorelbine affords treatment with two active drugs in women with metastatic breast cancer, and appears to have a favorable toxicity profile. A schedule of Doxil 40 mg/m2 day 1 and vinorelbine 30 mg/m2 days 1 and 15 given every 28 days is recommended for phase II studies. |
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Keywords: | Doxil metastatic breast cancer phase I vinorelbine |
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