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Docetaxel Plus Vinorelbine as Salvage Chemotherapy in Advanced Breast Cancer: A Phase II Study

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Abstract

Précis Administration of a combined regimen of docetaxel plus vinorelbine every 4 weeks is feasible and shows activity in heavily pretreated patients with advanced breast cancer.

Purpose. To determine the activity and tolerance of docetaxel plus vinorelbine in heavily pretreated patients with advanced breast cancer.

Methods. Thirty-five metastatic breast cancer patients with ECOG performance status of 0–2 received docetaxel (80 mg/m2 given intravenously) on day 1 and vinorelbine (30 mg/m2 given intravenously) on days 1 and 14, every 4 weeks. The median number of prior chemotherapy regimens was 2 (range: 1–4). Twenty-five patients (71.4%) had been treated previously using intensive therapy approaches with peripheral blood-derived stem cell (PBSC) support, including high-dose chemotherapy (11 patients), multicyclic dose-intensive chemotherapy supported with repeated PBSC infusions (seven patients), or both (seven patients). Twenty-eight patients (80%) received previous chemotherapy for metastatic disease. Adjuvant therapy in the remaining seven patients consisted of high-dose chemotherapy and PBSC support or an anthracycline-containing regimen.

Results. The total number of courses was 229, and the median number of courses per patient was 6 (range: 1–16). There was one toxic death (2.8%). Grade 3–4 toxicities included mucositis (17.1%), neutropenia (37.1%), anemia (5.7%), vomiting (2.9%), and asthenia (14.3%). Eighteen patients (58%; 95% CI: 40.6–75.4%) achieved an objective response, including four complete responses (12.9%) and 14 partial responses (45.1%). Overall response rate was 51.4% (95% CI: 34.8–67.9%). After a median follow-up of 20 months (range: 2–42), overall survival was 20 months (95% CI: 16–24), and median time to progression was 13 months (95% CI: 7–19).

Conclusion. This combination shows activity and an acceptable toxicity profile in patients with advanced breast cancer.

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References

  1. Honig SF: Lippman ME, Morrow M et al. (eds) Diseases of the Breast. Lippincot-Raven, Philadelphia, 1996, pp 669–7

  2. Fellous A, Ohayon R, Vacassin T, Binet S, Lataste H, Krikorian A, Couzinier JP, Meininger V: Biochemical effects of Navelbine on tubulin and associated proteins. Semin Oncol 16(2, suppl 4): 9–14, 19

    Google Scholar 

  3. Eisenhauer EA, Vermorken JB: The taxoids: comparative clinical pharmacology and therapeutic potential. Drugs 55: 5–30, 1998

    Google Scholar 

  4. Haldar S, Basu A, Croce CM: Bcl-2 is the guardian of microtubule integrity. Cancer Res 57(2): 229–233, 1997

    Google Scholar 

  5. Valero V, Holmes FA, Walters RS, Theriault RL, Esparza L, Fraschini G, Fonseca GA, Bellet RE, Buzdar AU, Hortobagyi GN: Phase II trial of docetaxel: a new, highly effective antineoplastic agent in the management of patients with anthracycline resistant metastatic breast cancer. J Clin Oncol 13(12): 2886–2894, 1995

    Google Scholar 

  6. Ravdin PM, Burris III HA, Cook G, Eisenberg P, Kane M, Bierman WA, Mortimer J, Genevois G, Bellet RE: Phase II trial of docetaxel in advanced anthracycline-resistant or anthracenedione-resistant breast cancer. J Clin Oncol 13(12): 2879–2885, 1995

    Google Scholar 

  7. Bonneterre J, Spielman M, Guastalla JP, Marty M, Viens P, Chollet P, Roche H, Fumoleau P, Mauriac L, Bourgeois H, Namer M, Bergerat JP, Misset JL, Trandafir L, Mahjoubi M: Efficacy and safety of docetaxel in heavily pretreated advanced breast cancer patients: the French compassionate use programme experience. Eur J Cancer 35(10): 1431–1439, 1999

    Google Scholar 

  8. Vogel M, Hilsenbeck SG, Deprenbock H, Danhauser-Riedl S, Block T, Nekarda H, Fellbaum C, Aapro MS, Bissery MC, Rastetter J: Preclinical activity of taxotere against freshly explanted clonogenic human tumor cells: comparison with taxol and conventional antineoplastic agents. Eur J Cancer 29A(14): 2009–2014, 1993

    Google Scholar 

  9. Hanauske AR, Degen D, Hilsenbeck SG, Bissery MC, Von Hoff DD: Effects of taxotere and taxol on in vitro colony formation of freshly explanted human tumor cells. Anticancer Drugs 3(2): 121–124, 1992

    Google Scholar 

  10. Marty M, Extra JM, Espie M, Leandri S, Besenval M, Krikorian A: Advances in vinca alcaloids: Navelbine. Nouv Rev Fr Hematol 31(2): 77–84, 1989

    Google Scholar 

  11. Gasparini G, Caffo O, Barni S, Frontini L, Testolin A, Gluglielmi RB: Vinorelbine is an active antiproliferative agent in pretreated advanced breast cancer patients. J Clin Oncol 12(10): 2094–2101, 19

    Google Scholar 

  12. Bissery MC, Vrignaud P, Bayssas M: In vivo evaluation of taxotere in combination with cisplatinum, doxorrubicin, or vincristine. Proc Am Assoc Cancer Res 33: 443, 1992 (abstract 2645)

    Google Scholar 

  13. Bissery MC, Vrignaud P, Bayssas M: Preclinical in vivo activity of docetaxel-containing combinations. Clin Oncol 14: 489, 1995(abstract 1599)

    Google Scholar 

  14. Aoe K, Kiura K, Ueoka H, Tabata M, Matsumura T, Chikamori M, Matsushita A, Kohara H, Harada M: Effect of docetaxel with cisplatin or vinorelbine on lung cancer cell lines. Anticancer Res 19(1A): 291–299, 1999

    Google Scholar 

  15. Fumoleau P, Delecroix V, Perrocheau G, Borg-Olivier O, Maugard C, Fety R, Azli N, Louboutin JP, Riva A: Docetaxel in combination with vinorelbine as first line chemotherapy in patients with metastatic breast cancer: final results. Proc Am Soc Clin Oncol 15: 126, 1996 (abstract 232)

    Google Scholar 

  16. Toussaint C, Izzo J, Spielmann M, Merle S, May-Levin F, Armand JP, Lacombe D, Tursz T, Sunderland M, Chabot GC: Phase I/II trial of continuous infusion vinorelbine for advanced breast cancer. J Clin Oncol 12: 2102–2112, 1994

    Google Scholar 

  17. Miller AB, Hoogstraten B, Staquet M, Winkler A: Reporting results of cancer treatment. Cancer 47(1): 207–214, 1981

    Google Scholar 

  18. Kaplan EL, Meier P: Non-parametric estimation from incomplete observations. J Am Stat Assoc 53: 457–481, 1959

    Google Scholar 

  19. Cox DR: The Analysis of Binary Data. Methuen, London, UK, 1970

  20. Hryniuk W, Bush H: The importance of dose intensity in chemotherapy of metastatic breast cancer. J Clin Oncol 2(11): 1281–1218, 1984

    Google Scholar 

  21. Swenerton KD, Legha SS, Smith T, Hortobagyi GN, Gehan EA, Yap HY, Gutterman JU, Blumenschein GR: Prognostic factors in metastatic breast cancer treated with combination chemotherapy. Cancer Res 39(5): 1552–1562, 1979

    Google Scholar 

  22. Hortobagyi GN, Smith TL, Legha SS, Swenerton KD, Gehan EA, Yap HY, Buzdar AU, Blumenschein GR: Multivariate analysis of prognostic factors in metastatic breast cancer. J Clin Oncol, 1(12): 776–786, 1983

    Google Scholar 

  23. Garcia-Rayo S, Perez-Calvo J, Martin Algarra S, Rebollo J, Samcam ME, Ordoñez JM, Santisteban M, Brugarolas A: Alternating sequential intensive chemotherapy with stem cell support in metastatic breast cancer. Proc Ann Meet Am Soc Clin Oncol, 1999(abstract 46

  24. Perez-Calvo J,Martinez Aguillo M, Garcia-Rayo S, Ramon Y, Cajal T, Santisteban M, Ordoñez JM, Brugarolas A: Factors determining the actually received dose intensity in a program of multicyclic dose-intensive alternating chemotherapy with sequential stem cell support. Acta Hematol. (in press

  25. Crown J, Raptis G, Hamilton N, Fennelly D, Vahdat L, Norton L: High dose chemotherapy of breast cancer: current status and developmental strategies. Eur J Cancer 31A(5): 809–811, 1995

    Google Scholar 

  26. Berruti A, Zola P, Buniva T, Bau MG, Farris A, Sarobba MG, Bottini A, Tampellini M, Durando A, Destefanis M, Monzeglio C, Moro G, Sussio M, Perroni D, Dogliotti L: Prognostic factors in metastatic breast cancer patients obtaining objective response or disease stabilization after firstline chemotherapy with epirubicin. Evidence for a positive effect of maintenance hormonal therapy on overall survival. Anticancer Res 17(4A): 2763–2768, 1997

    Google Scholar 

  27. Haldar S, Chintapalli J, Croce CM: Taxol induces bcl-2 phosphorylation and death of prostate cancer cells. Cancer Res 15, 56(6): 1253–1255, 1996

    Google Scholar 

  28. Verschueren H, Dewit J, De Braekeleer J, Schirrmacher V, De Baetselier P: Motility and invasive potency of murine Tlymphoma cells: effect of microtubules inhibitors. Cell Biol Int 18(1): 11–19, 1994

    Google Scholar 

  29. Stracke ML, Soroush M, Liotta LA, Schiffmann E: Cytoskeletal agents inhibit motility and adherence of human tumor cells. Kidney Int 43(1): 151–157, 1993

    Google Scholar 

  30. Adams DJ, Knick VC: P-glycoprotein mediated resistance to 5_-nor-anhydro-vinblastine. Invest New Drugs 13(1): 13–21, 1995

    Google Scholar 

  31. Bissery MC, Vrignaud P, Lavelle F: In vivo evaluation of docetaxel and vinorelbine as single agents and in combination in mammary tumor models. In: Calvo F, Crepin M, Magdelenat H (eds) Breast Cancer. Advances in Biology and Therapeutics. John Libbey Eurotext, Montrouge, France, 1996, pp 265–2

  32. Valero V, Jones SE, Von Hoff DD, Booser DJ, Mennel RG, Ravdin PM, Holmes FA, Rahman Z, Schottstaedt MW, Erban JK, Esparza-Guerra L, Earhart RH, Hortobagyi GN, Burris HA: A phase II study of docetaxel in patients with paclitaxelresistant metastatic breast cancer. J Clin Oncol 16(10): 3362–3368, 1998

    Google Scholar 

  33. Jaffrezou JP, Dumontet C, Derry WB, Duran G, Chen G, Tsuchiya E, Wilson L, Jordan MA, Sikic BI: Novel mechanism of resistance to paclitaxel in human K562 leukemia cells by combined selection with PSC 833. Oncol Res 7(10–11): 517–527, 1995

    Google Scholar 

  34. Parness J, Horwitz SB: Taxol binds to polymerized tubulin in vitro. J Cell Biol 91(2 Pt): 479–487, 1981

    Google Scholar 

  35. Bissery MC, Vrignaud P, Lavelle F: Preclinical profile of docetaxel: efficacy as a single agent and in combination. Semin Oncol 22(6, suppl 13): 3–16, 1995

    Google Scholar 

  36. Livingston RB, Ellis GK, Gralow JR: Dose-intensive vinorelbine with concurrent granulocyte colony-stimulating factor support in paclitaxel-refractory metastatic breast cancer. J Clin Oncol 15(4): 1395–1400, 1997

    Google Scholar 

  37. Van Oosterom AT, Schrijvers D: Docetaxel, a review of preclinical and clinical experience. Part II: Clinical experience. Anticancer Drugs 6(3): 356–368, 1995

    Google Scholar 

  38. Weber BL, Vogel C, Jones S, Harvey H, Hutchins L, Bigley J, Hohneker J: Intravenous vinorelbine as first-line and secondline therapy in advanced breast cancer. J Clin Oncol 13(11): 2722–2730, 1995

    Google Scholar 

  39. Marty M, Extra JM, Dieras V, Giachetti S, Ohana S, Espie M: A review of the antitumor activity of vinorelbine in breast cancer. Drugs 44(suppl 4): 29–35, 1992

    Google Scholar 

  40. Fumoleau P, Delozier T, Extra JM, Canobbio L, Delgado FM, Hurteloup P: Vinorelbine in the treatment of breast cancer: the European experience. Semin Oncol 22(2, suppl 5): 22–28, 1995

    Google Scholar 

  41. Gralow J, Ellis G, Williams M, Livingston R: Docetaxel plus vinorelbine with concurrent G-CSF support: a phase II study in stage IV breast cancer. Proc Ann Meet Am Soc Clin Oncol, 2000 (abstract 41

  42. De Paz L, Lluch A, Martin M, Garcia-Carbonero I, Azagra P, Chirivella I: A phase II study of docetaxel and vinorelbine in metastatic breast cancer. Proc Ann Meet Am Soc Clin Oncol, 1999 (abstract 45

  43. Frasci G, Comella P, D'Aiuto G, Thomas R, Capasso I, Elmo M, Botti G, Cortino GR, Lapenta L, De Rosa V, Vallone P, Petrillo A, Comella G: Weekly docetaxel plus gemcitabine or vinorelbine in refractory advanced breast cancer patients: a parallel dose-finding study. Southern Italy Cooperative Oncology Group. Ann Oncol 11(3): 367–371, 2000

    Google Scholar 

  44. Antman K, Ayash L, Elias A, Wheeler C, Hunt M, Eder JP, Teicher BA, Critchlow J, Bibbo J, Schnipper LE: A phase II study of high dose cyclophosphamide, thiotepa and carboplatin with autologous marrow support in women with measurable advanced breast cancer responding to standarddose chemotherapy. J Clin Oncol 10(1): 102–110, 1992

    Google Scholar 

  45. Henderson IC, Hayes DF, Gelman R: Dose response in the treatment of breast cancer: a critical review. J Clin Oncol 6(9): 1501–1515, 1988

    Google Scholar 

  46. Henderson IC: Window of opportunity. J Natl Cancer Inst 83(13): 894–896, 19

    Google Scholar 

  47. Davison NE: Out of the courtroom and into the clinic. J Clin Oncol 10(4): 517–519, 1992

    Google Scholar 

  48. Bearman S, Vredenburgh J, Cagnoni P, Shpall E, Nieto Y, Ross M, Peters WP, Jones RB: High dose therapy with autologous hematopoietic cell support as salvage treatment for patients with breast cancer who have relapsed after previous highdose chemotherapy. Bone Marrow Transplant 24(5): 491–495, 1999

    Google Scholar 

  49. Bueso P, Mayordomo JI, Cajal R: Activity of docetaxel plus vinorelbine in patients with metastatic breast cancer relapsing after high dose chemotherapy with stem cell rescue. Proc Ann Meet Am Soc Clin Oncol, 1999 (abstract 18

  50. Dieras V, Fumoleau P, Kalla S, Misset JL, Azli N, Pouillart P: Docetaxel in combination with doxorrubicin or vinorelbine. Eur J Cancer 33(suppl 7): S20–S22, 1997

    Google Scholar 

  51. Pronk LC, Stoter G, Verweij J: Docetaxel: single agent activity, development of combination treatment and reducing side effects. Cancer Treat Rev 21(5): 463–478, 1995

    Google Scholar 

  52. Campone M, Fumoleau P, Delecroix V, Deporte-Fety R, Perrocheau G, Vernillet L, Borg-Olivier O, Louboutin JP, Bissery M, Riva A, Azli N: Phase I dose-finding and pharmacokinetic study of docetaxel and vinorelbine as first-line chemotherapy for metastatic breast cancer. Ann Oncol 12(7): 909–918, 2001

    Google Scholar 

  53. Kornek G, Ulrich-Pur H, Penz M, Haider K, Kwasny W, Depisch D, Kovats E, Lang F, Schneeweiss B, Scheithauer W: Treatment of advanced breast cancer with vinorelbine and docetaxel with or without human granulocyte colony stimulating factor. J Clin Oncol 19(3): 621–627, 2001

    Google Scholar 

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Rodríguez, J., Calvo, E., Cortes, J. et al. Docetaxel Plus Vinorelbine as Salvage Chemotherapy in Advanced Breast Cancer: A Phase II Study. Breast Cancer Res Treat 76, 47–56 (2002). https://doi.org/10.1023/A:1020273502426

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