Overview of epirubicin-based adjuvant therapy in breast cancer.
Clinical trial data indicate that epirubicin-based adjuvant treatment of breast cancer is associated with marked improvement in relapse-free and overall survival compared with traditional cyclophosphamide/methotrexate/5-fluorouracil. The outcomes are comparable to those achieved with sequential use of doxorubicin/cyclophosphamide and paclitaxel. Dose intensification of epirubicin is feasible, with tolerable side effects and no increased risk of cardiotoxicity beyond that expected. Clinical trial data coupled with pharmacokinetic evidence provide a strong foundation and rationale for current and future investigation of epirubicin in combination with the taxanes in the adjuvant setting. An ongoing German study is evaluating epirubicin/cyclophosphamide in combination with trastuzumab as first-line therapy of metastatic breast cancer in patients whose tumors overexpress HER2/neu protein. These results, particularly the tolerability of this regimen, will form the basis for future adjuvant and neoadjuvant studies of epirubicin/trastuzumab-based regimens.
Untch
M
M
Department of Obstetrics and Gynecology, University of Munich, Germany. untch@gyn.med.uni-muenchen.de
von Koch
F
F
Kahlert
S
S
Konecny
G
G
D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D015251:Epirubicin / Q000008:administration & dosage / Q000627:therapeutic use*; D018734:Genes, erbB-2; D006801:Humans
D000903:Antibiotics, Antineoplastic; D015251:Epirubicin