High-dose infusional doxorubicin and cyclophosphamide: a feasibility study of tandem high-dose chemotherapy cycles without stem cell support

The purpose of this study was to determine the maximally tolerated dose of doxorubicin administered during two cycles of intensive chemotherapy with cyclophosphamide and doxorubicin without stem cell support in patients with advanced cancer and to assess the cumulative cardiac toxicity of the regime...

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Bibliographic Details
Published in:Clinical cancer research 1997-12, Vol.3 (12), p.2337-2345
Main Authors: R J Morgan, Jr, J H Doroshow, K Venkataraman, K Chang, J Raschko, G Somlo, L Leong, M Tetef, S Shibata, V Hamasaki, K Margolin, S Forman, S Akman, P Coluzzi, C Ahn, L Weiss, U Gadgil, J Harrison
Format: Article
Language:English
Subjects:
Adult
Antineoplastic agents
Antineoplastic Combined Chemotherapy Protocols - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biological and medical sciences
Breast Neoplasms - drug therapy
Breast Neoplasms - pathology
Chemotherapy
Cyclophosphamide - administration & dosage
Cyclophosphamide - adverse effects
Doxorubicin - administration & dosage
Doxorubicin - adverse effects
Drug toxicity and drugs side effects treatment
Feasibility Studies
Female
Filgrastim
Gated Blood-Pool Imaging
Granulocyte Colony-Stimulating Factor - therapeutic use
Heart - diagnostic imaging
Heart - drug effects
Humans
Infusions, Intravenous
Lymphatic Metastasis
Medical sciences
Middle Aged
Neoplasm Metastasis
Neoplasm Staging
Pharmacology. Drug treatments
Recombinant Proteins
Toxicity: cardiovascular system
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Summary:The purpose of this study was to determine the maximally tolerated dose of doxorubicin administered during two cycles of intensive chemotherapy with cyclophosphamide and doxorubicin without stem cell support in patients with advanced cancer and to assess the cumulative cardiac toxicity of the regimen by noninvasive radionuclide imaging and by pre-and postchemotherapy endomyocardial biopsies. Thirty-eight patients (thirty-six with high risk or metastatic breast cancer) were treated in a dose-escalation trial using a fixed dose of i.v. cyclophosphamide (4.2 g/m2) administered over 2 h on day 5 and escalating doses of doxorubicin (50-175 mg/m2) given as a 96-h continuous i.v. infusion on days 1-4, using Filgrastim (granulocyte colony-stimulating factor) for hematological support beginning on day 6. All patients underwent pretreatment, and 28 patients underwent postchemotherapy endomyocardial biopsies. Twenty-nine of 38 patients received two cycles of treatment (median number of days between cycles, 44; range, 34-62). Twenty-one patients had received doxorubicin previously at cumulative dose levels
ISSN:1078-0432
1557-3265