Cisplatin and etoposide as first-line chemotherapy for metastatic breast carcinoma: a prospective randomized trial of the Italian Oncology Group for Clinical Research.

Abstract

In this prospective randomized study, first-line treatment with the combination of cisplatin (P) and etoposide (E) was compared with the standard cyclophosphamide, methotrexate, and fluorouracil (CMF) combination in 140 patients. Complete remissions were obtained in 11% of 65 assessable patients on CMF and in 12% of 65 assessable patients on PE. Complete plus partial remission rates were 48% on CMF and 63% on PE (P = .08). Time to progression (median, 32 v 31 weeks), duration of response (48 v 39 weeks), and survival (75 v 76 weeks) were not different. Hematologic toxicity was significantly higher with PE, and gastrointestinal side effects were frequent with this treatment. This study demonstrated that the PE combination is effective as front-line chemotherapy. As far as response rate is concerned, a trend of superiority over CMF was observed, which was of borderline significance. Due to the lack of survival advantage and to toxicity, this combination is not recommended for routine clinical use. However, its high level of activity should be taken into account for further research.

Cisplatin plus oral etoposide (EoP) combination is more effective than paclitaxel in patients with advanced breast cancer pretreated with anthracyclines: a randomised phase III trial of Turkish Oncology Group

“…Toxicities observed in several phase II as well as in two randomised trials assessing the efficacy of EP in breast cancer have limited the use of this combination in breast cancer (Giaccone et al, 1988;Krook et al, 1990;Cocconi et al, 1991;Remick et al, 1996;Icli et al, 2001). However, the dosage of cisplatin in all these trials was higher when compared to the present trial (100 vs 70 mg m À2 ).…”

“…A higher response rate than that achieved with CMF was observed by giving EP as first-line treatment in a small randomised trial (Cocconi et al, 1991). Etoposide þ cisplatin was also found as an active treatment for ABC following anthracyclines in the several phase II trials (Cox et al, 1989;Krook et al, 1990;Icli et al, 1992;Remick et al, 1996).…”

Cisplatin and its analogues in the treatment of advanced breast cancer: a review

“…In the third trial, CAP achieved a response rate of 67% compared with 41% for the conventional FAC regimen (5FU, doxorubicin, cyclophosphamide), again without significant difference in median re-sponse duration or survival (Kolaric et al, 1989). In the fourth trial, an Italian group compared a novel combination of cisplatin and etoposide with a standard CMF regimen (Cocconi et al, 1991). Cisplatin and etoposide achieved a response rate of 63% compared with 48% for CMF (P = 0.08).…”

Platinum-Based Compounds for the Treatment of Metastatic Breast Cancer

“…The two compounds have different modes of action and toxicity, except for a common higher occurrence of myelosuppression and nausea/vomiting [31,32]. The combination of cisplatin and etoposide (PE) in the treatment of MBC as first-line therapy was investigated in four studies and showed an RR ranging from 24 to 63% (table 2) [33,34,35,36]. Major toxicities included neutropenia, thrombocytopenia and nausea/vomiting.…”