מתוך medicontext.co.il
By Anthony J. Brown, MD
WESTPORT, CT (Reuters Health) – Combination chemotherapy with monthly docetaxel and weekly gemcitabine is highly active in women with metastatic breast cancer who have received prior chemotherapy, according to the results of a phase II trial.
Dr. Leslie R. Laufman from Hematology Oncology Consultants, Inc. in Columbus, Ohio and colleagues assessed the outcomes of 39 women with metastatic breast cancer who were treated with the combination therapy. All of the women had received prior chemotherapy.
The treatment regimen consisted of 800 mg/m² of gemcitabine given on days 1, 8, and 15 and 100 mg/m² of docetaxel given on day 1, with cycles repeated every 4 weeks, the researchers note in the September issue of the Annals of Oncology.
Two complete and 29 partial responses occurred for an overall response rate of 79%. In fact, 25 of the responders showed no evidence of disease progression for more than 6 months. The median survival was just over 2 years, the authors state.
Nearly all patients experienced grade 4 neutropenia. Asthenia was the most common non-hematologic toxicity and 13 patients experienced grade III asthenia, the investigators state.
"Gemcitabine, when used as a single agent to treat metastatic breast cancer, has a response rate of 20% to 30%," Dr. Laufman told Reuters Health. "Docetaxel, which is usually given every 3 weeks, is associated with a response rate of 45% at a dose of 75 mg/m² and 55% at a dose of 100 mg/m²," she noted.
"Prior studies which have investigated gemcitabine/docetaxel combination therapy really haven't shown response rates any better than with docetaxel alone," Dr. Laufman pointed out. "Our response rate of 79% was much higher, and I think the difference may have been that we used a 4-week docetaxel schedule, while they used a 3-week schedule," she explained, adding that the toxicities of a 3-week schedule may cause treatment discontinuation.
"We didn't use prophylactic filgrastim in the current study, yet our rate of febrile neutropenia was similar to those of other studies which did use it," Dr. Laufman said. However, most patients received prophylactic antibiotics during periods of severe neutropenia, she added.
Dr. Laufman mentioned that her team is "doing another phase II trial using 75 mg/m² of docetaxel instead of 100 mg/m²."
Most doctors are "probably uncomfortable with the severity of neutropenia described in the current study, so perhaps a lower dose of docetaxel will limit the extent of this toxicity," she said.
Ann Oncol
e-Med Tools
קצר קולע וממוקד
e-Med סמינרים
אי-מד תחקירים
Medscape Tools
Journal Club
מרכזי מידע ושירות
Facebook
מידע למפרסם
מאגר תרופות
מאגר אנשי המקצוע
אינדקס שימושי
חדשות משה"ב
eMed HealthClub
מחקרים קליניים
השאירו תגובה
רוצה להצטרף לדיון?תרגישו חופשי לתרום!