Phase I/II trial of weekly epidoxorubicin and docetaxel (wED) in the neoadjuvant and palliative treatment of patients with breast cancer.
OBJECTIVE
Anthracyclines and taxanes are the most active cytotoxic agents in the treatment of breast cancer. Based on observations with weekly administration of paclitaxel which results in better tolerability and higher dose intensity as compared with 3-weekly schedules, we designed a phase I/II trial with weekly epidoxorubicin and docetaxel (wED) for the preoperative and palliative treatment of patients with breast cancer.


METHODS
A group of 33 female patients (20 neoadjuvant and 13 palliative) were treated with weekly epidoxorubicin (25-35 mg/m(2)) as a short i.v. infusion followed by docetaxel (25-40 mg/m(2)) as a 1-h i.v. infusion once a week for 6 weeks followed by 1 week off therapy, without G-CSF support. Sequential cohorts of patients were treated with epirubicin and docetaxel at the following dose levels: 25/25, 25/30, 30/30, 30/35, 35/35, and 35/40 mg/m(2).


RESULTS
Patients received a total of 74 courses (median 2, range 1-4 courses) of this therapeutic regimen. The maximum tolerated dose occurred at the dose level combining 35 mg/m(2) of epidoxorubicin and 40 mg/m(2) of docetaxel, with the dose-limiting toxicity being neutropenic fever in two patients at dose level 6.


CONCLUSIONS
The wED regimen is a feasible, safe, and highly active combination chemotherapy for advanced breast cancer. We recommend epidoxorubicin 30 mg/m(2) and docetaxel 35 mg/m(2) for further trials because of the high incidence of neutropenic fever and lymphocytopenia of WHO grade IV at dose levels 5 and 6.
Wenzel
Catharina
C
Department of Internal Medicine I/Division of Oncology, University Hospital of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Locker
Gottfried J
GJ
Pluschnig
Ursula
U
Zielinski
Christoph C
CC
Rudas
Margarethe
M
Oberhuber
Gerhard
G
Gnant
Michael F
MF
Taucher
Susanne
S
Jakesz
Raimund
R
Steger
Guenther G
GG
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005334:Fever / Q000139:chemically induced; D006801:Humans; D008231:Lymphopenia / Q000139:chemically induced; D008593:Menopause; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009503:Neutropenia / Q000139:chemically induced; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D010166:Palliative Care; D011446:Prospective Studies; D012449:Safety; D043823:Taxoids / Q000031:analogs & derivatives; D016896:Treatment Outcome
D043823:Taxoids; D004317:Doxorubicin; D017239:Paclitaxel