Paclitaxel combined with ifosfamide in anthracycline-and docetaxel-pretreated metastatic breast cancer: Activity independence of prior docetaxel resistance

Yong Wha Moon, Joo Hyuk Sohn, Hye Jin Choi, Hyun Chang, Byeong Woo Park, Seung Il Kim, Seho Park, Ja Seung Koo, Yong Tai Kim, Jae Kyung Roh, Hyun Cheol Chung, Joo Hang Kim

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Abstract

Background: We evaluated the efficacy and tolerability of combined paclitaxel and ifosfamide in anthracycline-and docetaxel-pretreated metastatic breast cancer (MBC). Methods:Patients received paclitaxel (175 mg/m2 i.v. in a 3-h infusion) on day 1 and ifosfamide (1.5 g/m2 i.v. in a 15-min infusion) on days 1-3, every 3 weeks for a maximum of nine cycles. The tumor response was assessed every two cycles. Results: We enrolled 34 patients with a median age of 50 years. Thirty patients had visceral metastases. Anthracycline-and docetaxel-based chemotherapy had previously been administered to 18/13 and 13/21 patients, respectively, in (neo)adjuvant/metastatic settings. Three patients had not previously received anthracycline due to abnormal cardiac functions. A total of 174 cycles of chemotherapy were delivered with a median of six cycles. The response rate under the intent-to-treat analysis was 23.5% (all partial responses) with a median response duration of 14 months. The disease control rate was 70.6%. The median progression-free and overall survival were 5.9 and 8.5 months, respectively. There was no apparent relationship between activity and prior docetaxel resistance. The incidence of grade III/IV neutropenia was 46.6% (81 of 174 cycles) with febrile neutropenia of only 1.7%. Major grade III/IV nonhematological toxicities included peripheral neuropathy (6 of 34 patients) and infection (4 of 34 patients). There were no treatment-related deaths. Conclusion:Paclitaxel combined with ifosfamide was effective and tolerable in anthracycline-/docetaxel-pretreated MBC. Overcoming docetaxel resistance by using paclitaxel in combination with ifosfamide needs to be addressed through further investigation.

Original languageEnglish
Pages (from-to)425-431
Number of pages7
JournalCancer Chemotherapy and Pharmacology
Volume66
Issue number3
DOIs
Publication statusPublished - 2010 Aug

All Science Journal Classification (ASJC) codes

  • Oncology
  • Toxicology
  • Pharmacology
  • Cancer Research
  • Pharmacology (medical)

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