title: The use of granulocyte colony-stimulating factor to deliver four cycles of ifosfamide and epirubicin every 14 days in women with advanced or metastatic breast cancer.
abstract: Twenty patients with locally advanced or metastatic breast cancer were treated with four cycles of ifosfamide/mesna 5 g m-2 and epirubicin 60 mg m-2 every 14 days with granulocyte colony-stimulating factor (G-CSF, Filgrastim). Complete remission occurred in six out of the 20 patients (30%, 95% confidence interval 12-54%) and there were 12 partial responders (60%, 95% confidence interval 37-81%), thus giving an overall response rate of 90% (95% confidence interval 63-97%). Two patients had progressive disease. The median duration of response for those patients with metastatic disease was 7.3 (1.3-20.1+) months. The median survival time for these patients was 15 (5.3-27.9+) months. Of the four patients treated with locally advanced disease three achieved a complete clinical response and one a partial response. Three out of four of these patients subsequently underwent a mastectomy, and in one of these no viable tumour was seen. Our conclusion is that this regimen is excellent palliation for metastatic disease and possibly useful neoadjuvant treatment.
authors.affiliation: Department of Clinical Oncology, Newcastle General Hospital, Newcastle upon Tyne, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Lind
authors.forename: L
authors.initials: L
authors.lastname: Gumbrell
authors.forename: B M
authors.initials: BM
authors.lastname: Cantwell
authors.forename: M J
authors.initials: MJ
authors.lastname: Millward
authors.forename: D
authors.initials: D
authors.lastname: Simmonds
authors.forename: M
authors.initials: M
authors.lastname: Proctor
authors.forename: F
authors.initials: F
authors.lastname: Chapman
authors.forename: E
authors.initials: E
authors.lastname: McCann
authors.forename: I
authors.initials: I
authors.lastname: Middleton
authors.forename: A H
authors.initials: AH
authors.lastname: Calvert
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D004334:Drug Administration Schedule; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects; D015080:Mesna / Q000008:administration & dosage; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009503:Neutropenia / Q000139:chemically induced / Q000188:drug therapy
chemical_list: D016179:Granulocyte Colony-Stimulating Factor; D015251:Epirubicin; D015080:Mesna; D007069:Ifosfamide