Weekly Paclitaxel in the Treatment of Advanced or Metastatic Breast Cancer Previously Treated or Not Treated with Docetaxel: A Phase II Study

Nishimura, Reiki; Ogawa, Takahiro; Kato, Masato; Tanaka, Maki; Hamada, Yoshiaki; Shibata, Takao; Ishikawa, Emi; Koga, Toshihiro; Mitsuyama, Shoshu; Tamura, Kazuo

doi:10.1159/000085620

Cited by 14 publications

(9 citation statements)

References 13 publications

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“…However, PTX shifts the equilibrium toward microtubule assembly and stabilizes microtubules by preventing depolymerization [19]. As a result, PTX is reported to lack complete cross-resistance with DOC in several types of carcinomas [20][21][22]. Regarding ESCC, PTX monotherapy shows feasible efficacy, with an overall response rate of 44.2%, median duration of response of 4.8 months, and median OS of 10.4 months with manageable toxicity as a second-line regimen for patients previously treated with platinumbased chemotherapy [5].…”

Section: Discussionmentioning

confidence: 99%

A Pilot Trial of S-1 and Paclitaxel in Unresectable or Postoperative Recurrent Esophageal Squamous Cell Carcinoma Pretreated by Fluorouracil, Cisplatin, and Docetaxel Chemotherapy

Nakajima

Kawada²,

Tokairin³

et al. 2017

Dig Surg

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Background/Aims: This study documents the clinical efficacy and toxicity of S-1 and paclitaxel (S1/PTX) in patients with unresectable or postoperative recurrent esophageal squamous cell carcinoma (ESCC) who had been previously treated with fluorouracil (5FU), cisplatin, and docetaxel. Methods: Twenty-eight ESCC patients treated using S1/PTX at our institute since 2010 were enrolled in this study. S1 was administered orally at a dose of 80 mg/m²/day from days 1 to 14, and PTX was administered intravenously on days 1 and 8 at a dose of 80-100 mg/m². Results: A total of 106 cycles (median 2.5 cycles, range 1-12 cycles) were administered. The response rate was 14.8%, including 3 complete responses. The median progression-free survival time was 137 days, and the median overall survival time was 306 days. Severe neutropenia occurred in 13 patients, and 3 showed febrile neutropenia. All non-hematological toxicities were mild, and peripheral nerve paralysis was observed in 2 patients. Conclusion: S1/PTX was found to have tolerable clinical efficacy in terms of the response rate, survival and toxicity in patients with unresectable or postoperative recurrent ESCC who had previously been treated with 5FU, cisplatin, and docetaxel.

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Section: Discussionmentioning

confidence: 99%

A Pilot Trial of S-1 and Paclitaxel in Unresectable or Postoperative Recurrent Esophageal Squamous Cell Carcinoma Pretreated by Fluorouracil, Cisplatin, and Docetaxel Chemotherapy

Nakajima

Kawada²,

Tokairin³

et al. 2017

Dig Surg

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“…We previously reported that weekly paclitaxel was effective in metastatic breast cancer with acceptable toxicity [23] , and therefore, it is conceivable that a paclitaxel and anthracycline combination could be an alternative to ET therapy. However, the previous study reported that the paclitaxel and doxorubicin combination had a higher incidence of cardiac failure.…”

Section: Discussionmentioning

confidence: 99%

Dose Escalation Study of Epirubicin and Docetaxel in Patients with Advanced or Recurrent Breast Cancer

Ichinose

Hamada²,

Mitsuyama³

et al. 2008

Chemotherapy

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Background: Anthracyclines and taxanes are major cytotoxic drugs against breast cancer. To develop a combination of epirubicin (EPI) and docetaxel (DTX) in Japan, dose escalation and pharmacokinetic studies were performed in patients with advanced or recurrent breast cancer. Methods: Twenty patients received EPI (40, 50 or 60 mg/m²) as 5-min intravenous infusion, followed by DTX infusion (50 or 60 mg/m²) over 1 h in cohorts of 3–6 patients. The maximum tolerated dose (MTD) was defined during the first cycle when more than 2 of 3 or 3 of 6 patients suffered a dose-limiting toxicity (DLT). The DLT was based on febrile neutropenia (FN), prolonged neutropenia, thrombocytopenia and grade 3–4 nonhematological toxicity during the first cycle. Plasma sampling was performed to assess the pharmacokinetic study of these drugs. Results: The second level (EPI/DTX 50/50 mg/m²) was found to be a maximum tolerated dose because of a short duration of FN with no distress. Subsequently, the protocol was modified to permit a new DLT definition including FN lasting for more than 72 h. At the following levels of EPI/DTX 50/50, 50/60 or 60/60 mg/m², the dose escalation study revealed a high incidence of grade 4 neutropenia (100%) and FN (67%), which did not reach DLT. However, the safety committee decided not to go further because of too high an incidence of FN lasting 3 days, although a little less than 72 h. The pharmacokinetic study with a combination of EPI and DTX showed comparable blood levels of DTX and EPI in relation to those seen when given alone. Conclusion: For further evaluation, the recommended dose and schedule of this combination is EPI 60 mg/m² and DTX 60 mg/m², given every 3 weeks to patients without prior chemotherapy and EPI 50 mg/m² and DTX 50 mg/m² given to patients with prior chemotherapy, respectively. The pharmacokinetic study indicates no interaction between EPI and DTX.

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“…Similarly, agents other than docetaxel should be considered for use in patients whose disease progresses within 1 year of receiving adjuvant therapy with docetaxel, although there is no widely accepted standard treatment. The results of several phase II studies have shown that weekly paclitaxel is modestly effective in patients with docetaxel-resistant MBC, with response rates of 20-41% and TTPs of 5.0-7.2 months [13][14][15].…”

Section: Patients Who Have Received Paclitaxel or Docetaxelmentioning

confidence: 99%

Considerations in treatment choice for metastatic breast cancer

Jones

2007

Breast Cancer

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Chemotherapy treatment choices for metastatic breast cancer (MBC) have become increasingly complex as therapeutic options multiply. In addition, the more frequent use of adjuvant chemotherapy coupled with the introduction of new standard adjuvant therapies has made these choices more difficult. Another issue that remains unsettled is whether to employ combination therapy or to use each agent singly until its value is exhausted. The results of recent studies investigating this issue have revealed higher response rates, time to tumor progression and, in some cases, improved overall survival with doublet therapy. However, there was no planned crossover in these trials and, as such, the absolute benefits of doublet therapy remain undetermined. The future of therapy for MBC appears to be combining effective single-agent chemotherapy with novel biologic agents. For example, compared with paclitaxel alone, therapy comprising paclitaxel plus bevacizumab produced a doubling of response rate and progression-free survival. However, similar data are required for both the first- and the second-line setting, and for other chemotherapy agents, for example, docetaxel and navelbine. Trastuzumab is the treatment of choice for patients with HER2-positive tumors. Its use in combination with chemotherapy, particularly the taxanes, is well established. However, much remains to be learned about biologic agents; for example, trials need to establish whether these therapies should be continued at the time of progression or whether other treatments should be given in their place. A recent study in patients whose disease had progressed after trastuzumab and chemotherapy and who were subsequently given lapatinib, has reported promising outcomes for this agent. When presented with the many options that are now available for the treatment of MBC, we must keep in mind the primary goal of such treatment: palliation of disease with minimal toxicity. Furthermore, a concurrent requirement for prolongation of survival is now commonplace. However, it is clear that there is currently no "gold standard" treatment for MBC, although the future of therapy appears to be the combination of effective single agents with novel biologic therapies.

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Weekly Paclitaxel in the Treatment of Advanced or Metastatic Breast Cancer Previously Treated or Not Treated with Docetaxel: A Phase II Study

Cited by 14 publications

References 13 publications

A Pilot Trial of S-1 and Paclitaxel in Unresectable or Postoperative Recurrent Esophageal Squamous Cell Carcinoma Pretreated by Fluorouracil, Cisplatin, and Docetaxel Chemotherapy

A Pilot Trial of S-1 and Paclitaxel in Unresectable or Postoperative Recurrent Esophageal Squamous Cell Carcinoma Pretreated by Fluorouracil, Cisplatin, and Docetaxel Chemotherapy

Dose Escalation Study of Epirubicin and Docetaxel in Patients with Advanced or Recurrent Breast Cancer

Considerations in treatment choice for metastatic breast cancer

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