Weekly vinorelbine versus docetaxel for metastatic breast cancer after failing anthracycline treatment.
BACKGROUND
Vinorelbine and docetaxel are active in anthracycline-pretreated, metastatic breast cancer. We compared their efficacy.


METHODS
Patients were randomized to receive weekly vinorelbine (VIN) or weekly docetaxel (DOC), 6 weekly doses per 8-week cycle, with optional crossover (X-DOC vs. X-VIN. The primary end point was time to progression (TTP) on initial treatment. Remission induction, survival, and quality of life were secondary end points.


RESULTS
Among 122 poor risk patients, a non-significant trend for better TTP was seen for DOC, both on initial and on crossover treatment. Responses were seen on either treatment, but progression was more common with VIN than with DOC, while more patients had a response with X-DOC than with X-VIN. Survival was identical in those receiving only the initial VIN vs. DOC and in the subgroups receiving crossover treatments. Grade 3-4 toxicity, especially hematological toxicity resulting in treatment delay, was more common with VIN. Non-graded toxicity contributed to abandoning DOC. Quality of life scores reflected worse results in patients crossing treatment arms, in either direction.


CONCLUSIONS
DOC showed marginally better activity but did not improve TTP or other endpoints over VIN in this poor risk population.
Meier
Carl Richard
CR
Klinikum Bremen-Mitte, Bremen, Germany. meiercr@mac.com
Illiger
Hans-Jochen
HJ
Steder
Martin
M
Janssen
Jan
J
Deertz
Holger
H
Braun
Manfred
M
Oeney
Hueseyin-Taylan
HT
Deuss
Burkhard
B
Küchler
Thomas
T
Rotermund
Susanne
S
D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage*; D001859:Bone Neoplasms / Q000556:secondary; D001943:Breast Neoplasms / Q000188:drug therapy*; D000077143:Docetaxel; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D043823:Taxoids / Q000008:administration & dosage*; D017211:Treatment Failure; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000077235:Vinorelbine
D018943:Anthracyclines; D043823:Taxoids; D000077143:Docetaxel; D014747:Vinblastine; D000077235:Vinorelbine