Paclitaxel: epirubicin in metastatic breast cancer--a review.
BACKGROUND
Treatment of metastatic breast cancer (MBC) with paclitaxel (T) and doxorubicin has yielded high response rates but the regimen is associated with significant cardiac toxicity. Epirubicin (E) is a less cardiotoxic anthracycline which has also been combined with paclitaxel in the treatment of MBC.


METHODS
This paper is a review of studies evaluating the pharmacokinetics, toxicity profile, and efficacy of the ET combination in MBC.


RESULTS
The ET combination has been studied extensively in Europe. The unique pharmacokinetics of the combination do not lead to the accumulation of cardiotoxic metabolites as in the case of the doxorubicin-paclitaxel combination. In terms of efficacy, the ET combination yields an overall response rate of 50%-70% and complete response rate (CR) 10%-15% in MBC in the same range as the more recent doxorubicin paclitaxel studies.


CONCLUSIONS
In summary the ET combination is safe and effective in MBC. It is less cardiotoxic than the doxorubicin paclitaxel combination. Further studies with ET in both the adjuvant setting and in MBC are in progress.
Razis
E D
ED
1st Department of Medical Oncology, Hygeia Hospital, Athens, Greece. edrazis@hol.gr
Fountzilas
G
G
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D015251:Epirubicin / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D009362:Neoplasm Metastasis / Q000188:drug therapy; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D043823:Taxoids; D016896:Treatment Outcome
D043823:Taxoids; D015251:Epirubicin; D017239:Paclitaxel