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

Abstract

Our objective was to determine whether oral etoposide and cisplatin combination (EoP) is superior to paclitaxel in the treatment of advanced breast cancer (ABC) patients pretreated with anthracyclines. From December 1997 to August 2003, 201 patients were randomised, 100 to EoP and 101 to paclitaxel arms. Four patients in each arm were ineligible. The doses of etoposide and cisplatin were 50 mg p.o. twice a day for 7 days and 70 mg m À2 intravenously (i.v.) on day 1, respectively, and it was 175 mg m À2 on day 1 for paclitaxel. Both treatments were repeated every 3 weeks. A median of four cycles of study treatment was given in both arms. The response rate obtained in the EoP arm was significantly higher (36.3 vs 22.2%; P ¼ 0.038). Median response duration was longer for the EoP arm (7 vs 4 months) (P ¼ 0.132). Also, time to progression was significantly in favour of the EoP arm (5.5 vs 3.9 months; P ¼ 0.003). Median overall survival was again significantly longer in the EoP arm (14 vs 9.5 months; P ¼ 0.039). Toxicity profile of both groups was similar. Two patients in each arm were lost due to febrile neutropenia. The observed activity and acceptable toxicity of EoP endorses the employment of this combination in the treatment of ABC following anthracyclines.

A literature-based meta-analysis taxane-based doublet versus single-agent taxane chemotherapy in patients with advanced breast cancer

“…1) (Nabholtz et al 1997(Nabholtz et al , 1999Sjostrom et al 1999;Sparano et al 2009;Albain et al 2008;Fountzilas et al 2009;Verma et al 2005;Icli et al 2005;O'Shaughnessy et al 2002). Of these, 4 trials were excluded (1,268 patients) because of the absence of taxanes in the experimental arm (Nabholtz et al 1997(Nabholtz et al , 1999Sjostrom et al 1999;Icli et al 2005).…”

Capecitabine and Cisplatin Combination Is an Active and Well-Tolerated Doublet in the Treatment of Metastatic Breast Carcinoma Patients Pretreated with Anthracycline and Taxanes

“…The addition of epirubicin to Cisp and Cap (EXC regimen) as neoadjuvant chemotherapy in locally advanced or inflammatory breast carcinoma also improved the overall and complete response rates (74 and 13%) to the cost of chemotherapyinduced nausea/vomiting and hypercoagulable disorders [20] . Although Cisp can infrequently cause serious unfavorable dose-limiting side effects including nephropathy, ototoxicity and cumulative dose-related peripheral neuropathy and myelosuppression, it is an effective chemotherapeutic option in pretreated MBC patients, and even in combination with etoposide, it may be an alternative to taxanes [21] . In the present study, most common adverse events related to CapCisp chemotherapy were mild nausea/vomiting and fatigue.…”

A multicenter phase II trial of docetaxel and capecitabine as salvage treatment in anthracycline- and taxane-pretreated patients with metastatic breast cancer

“…There are also other combination regimens with gemcitabine, cisplatin, vinorelbine, epirubicin, or etoposide with high response rates often in heavily pretreated patients, but without superior survival when compared to less toxic regimens or even single agents. An exception may be the case of triple-negative breast cancer and breast cancer 1 gene (BRCA1)-associated carcinomas, where platinum agents may have increased activity [33][34][35][36][37][38][39]. Recently was found that treatment with eribulin, a non-taxane microtubule dynamics inhibitor with a novel mode of action, improved overall survival in women with MBC whose disease progressed despite multiple rounds of prior chemotherapy, according to the results of a phase III clinical trial called EMBRACE [40].…”