Evaluation of the continuous infusion of etoposide plus cisplatin in metastatic breast cancer a collaborative north central cancer treatment group/mayo clinic phase ii study

Abstract

A prospective clinical trial was done to evaluate the efficacy and toxicity of cisplatin plus etoposide (VP-16) in patients with breast cancer who failed one previous chemotherapy regimen for advanced disease or relapsed within 12 months of adjuvant chemotherapy. Partial responses occurred in 11 of 44 evaluable patients (25%; 95% confidence interval (CI), 13% to 40%). The median time to disease progression in responding patients was 4 months (range, 3 to 6+ months), whereas the median time to disease progression and survival for all patients who were treated were 3 and 7 months, respectively. There was marked toxicity related to this protocol treatment including pancytopenia, gastrointestinal upset, and renal in-sufficiency. Two treatment-related deaths occurred; one from sepsis and one from renal failure. Thus, this regimen, as second-line chemotherapy for women with metastatic breast cancer, resulted in moderate, short-term, antitumor activity at the expense of marked toxicity.

Searching for the Magic Bullet: Anticancer Platinum Drugs Which Can Be Accumulated or Activated in the Tumor Tissue

“…The efficacy of cisplatin plus etoposide was evaluated in breast cancer patients who had failed one previous chemotherapy regimen for advanced disease or had relapsed within 12 months of adjuvant chemotherapy [98]. Etoposide (130 mg/m 2 /day) was initially given as a continuous infusion for 3 consecutive days and cisplatin (45 mg/m 2 /day) as a continuous infusion for the latter 48 hours of the etoposide administration.…”

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 ).…”

“…The efficacy of EP was assessed in eight phase 2 trials including 260 patients previously treated for ABC (Athanassiades et al, 1986;Cocconi et al, 1986;Giaccone et al, 1988;Cox et al, 1989;Krook et al, 1990;Icli et al, 1992;Ceci et al, 1995;Remick et al, 1996). A total response rate of 26.8% was obtained by giving etoposide 100 -130 mg m À2 i.v.…”

“…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). Furthermore, 42 and 50% response rates with acceptable side effects were reported by prolonged administration of oral EoP in two phase II trials, which were higher than those obtained by giving paclitaxel in ABC patients pretreated with anthracyclines (Icli and Demirkazik, 1998;Fried et al, 2000).…”

Cisplatin & IV Etoposide combination in the treatment of advanced breast cancer pretreated with anthracyclines

“…The responses, in general, were complete and partial, the first comprising 33.3% while the second comprising 66.6% of responders. [11] 260 70 (26.8) ---Icli F, et al [5] 35 15 (42.8) -6 8 Fried G, et al [12] 26 13 (50) -7 -TOG [1] 100 (36 Toxicity: The type of toxicity that occurred was hematological (increasing anemia 22 due to repeated vomiting, anorexia), infections due to leucopenia 9, and bleeding due thrombocytopenia 3) and treated accordingly by giving blood, heavy antibiotics and platelets. Gastro-intestinal (severe nausea 1, severe vomiting 1, anorexia 9, diarrhea 1, and abdominal pain 3), renal (acute renal failure due to dehydration 5, or precipitation of cisplatin in renal tubules 2), and dermatological (nonspecific rash 5, allergy to drug 33, or skin swelling and ulceration due extravasation of drug in skin 16).…”