title: Amifostine as chemoprotectant in metastatic breast cancer patients treated with doxorubicin.
abstract: Amifostine has shown to selectively protect normal tissues against cytotoxic and mutagenic effects of several anti-neoplastic drugs, such as alkylating agents, organoplatinum compounds, anthracyclines, taxanes, and ionising radiation. This cytoprotection is broad-spectrum and selective, without loss of therapeutic efficacy. In this study we have treated 31 patients affected with inoperable or metastatic breast cancer, not previously submitted to chemotherapy for advanced disease, with amifostine 910 mg/m(2) followed by doxorubicin 75 mg/m(2). The overall response rate was 52% with a median response duration of 13 months (range 6-53+) and a median overall survival of 21 months (range 3-59+). With regard to toxicity, 14 patients (45%) experienced transient g4 neutropenia which was febrile only in one case (3%). Grade 3-4 thrombocytopenia was not recorded. Nausea and vomiting occurred in 14% of cycles. Grade 3 mucositis was observed in only 1 patient, whereas 2 patients (6%) developed an asymptomatic drop of left ventricular ejection fraction (LVEF) >10% below basal value. In conclusion, this study suggests that amifostine can reduce doxorubicin related toxicity, thus improving the patients' quality of life and the efficacy/toxicity ratio of this drug.
authors.affiliation: Operative Unit of Medical Oncology, Oncology Institute of Bari, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Catino
authors.forename: Enrico
authors.initials: E
authors.lastname: Crucitta
authors.forename: Agnese
authors.initials: A
authors.lastname: Latorre
authors.forename: Domenico
authors.initials: D
authors.lastname: Sambiasi
authors.forename: Pietro
authors.initials: P
authors.lastname: Calabrese
authors.forename: Vito
authors.initials: V
authors.lastname: Lorusso
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary; D000328:Adult; D000368:Aged; D004999:Amifostine / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001772:Blood Cell Count; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D008875:Middle Aged; D012983:Soft Tissue Neoplasms / Q000188:drug therapy / Q000556:secondary; D015996:Survival Rate
chemical_list: D004317:Doxorubicin; D004999:Amifostine