Doxorubicin-paclitaxel: A safe regimen in terms of cardiac toxicity in metastatic breast carcinoma patients. Results from a European organization for research and treatment of cancer multicenter trial

The potential cardiotoxicity of the doxorubicin-paclitaxel regimen, when paclitaxel is given shortly after the end of the anthracycline infusion, is an issue of concern, as suggested by small single institution Phase II studies. In a large multicenter Phase III trial, 275 anthracycline naive metasta...

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Bibliographic Details
Published in:Cancer 2003, Vol.97 (1), p.40-45
Main Authors: BIGANZOLI, Laura, CUFER, Tanja, HAMILTON, A, PICCART, Martine, BRUNING, Peter, COLEMAN, Robert E, DUCHATEAU, Luc, RAPOPORT, Bernardo, NOOIJ, Marianne, DELHAYE, Francois, MILES, D, SULKES, Aaron
Format: Article
Language:English
Subjects:
Adenocarcinoma - drug therapy
Adenocarcinoma - secondary
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biological and medical sciences
Breast Neoplasms - drug therapy
Breast Neoplasms - pathology
Cyclophosphamide - administration & dosage
Disease Progression
Disease-Free Survival
Doxorubicin - administration & dosage
Drug toxicity and drugs side effects treatment
Female
Follow-Up Studies
Heart - drug effects
Humans
Medical sciences
Middle Aged
Paclitaxel - administration & dosage
Pharmacology. Drug treatments
Risk Factors
Safety
Survival Rate
Toxicity: blood
Treatment Outcome
Citations: Items that this one cites
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Summary:The potential cardiotoxicity of the doxorubicin-paclitaxel regimen, when paclitaxel is given shortly after the end of the anthracycline infusion, is an issue of concern, as suggested by small single institution Phase II studies. In a large multicenter Phase III trial, 275 anthracycline naive metastatic breast carcinoma patients were randomized to receive either doxorubicin (60 mg/m(2)) followed 30 minutes later by paclitaxel (175 mg/m(2) 3-hour infusion; AT) or a standard doxorubicin-cyclophosphamide regimen (AC; 60/600 mg/m(2)). Both treatments were given once every 3 weeks for a maximum of six cycles. Close cardiac monitoring was implemented in the study design. Congestive heart failure (CHF) occurred in three patients in the AT arm and in one patient in the AC arm (P = 0.62). Decreases in left ventricular ejection fraction to below the limit of normal were documented in 33% AT and 19% AC patients and were not predictive of CHF development. AT is devoid of excessive cardiac risk among metastatic breast carcinoma patients, when the maximum planned cumulative dose of doxorubicin does not exceed 360 mg/m(2).
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.10914