Mitoxantrone as first-line chemotherapy in advanced breast cancer: results of a collaborative European study

Abstract

Mitoxantrone (Novantrone; dihydroxyanthracenedione) is a substituted anthraquinone with a spectrum of activity similar to doxorubicin in experimental tumors. One hundred and seventy three patients with advanced breast cancer and no prior cytotoxic therapy for advanced disease entered a phase II study of mitoxantrone, 14 mg/m2 i.v. repeated every 3 weeks. At the time of this analysis 116 patients were evaluable. Eight patients achieved a complete response and 27 a partial response, the overall response rate being 30% (95% confidence limits: 22-39%). The median time until response was recorded was 15 weeks. The median duration of response was 74+ weeks and the median time to progression or death for all 116 patients was 22+ weeks. Mitoxantrone was well tolerated with myelosuppression as the dose-limiting toxicity. The most frequent non-haematological toxicities were nausea and vomiting (65%) but they were rarely severe. Total alopecia occurred in only 6% of the patients. Four patients developed clinically significant evidence of cardiotoxicity after cumulative mitoxantrone doses of 174-256 mg/m2. Thus, mitoxantrone offers comparable efficacy and less acute toxicity than the most active single agents currently available in the treatment of advanced breast cancer.

Cisplatin, Methotrexate and Mitoxantrone in Patients with Metastatic or Advanced Urothelial Cancer

“…cisplatin every 3 weeks, severe hematological toxicity was registered (17), indicating that the combination of mitoxantrone and cisplatin is toxic, as mitoxantrone alone (10-14 mg/m 2 every 3 weeks) has been described as being mildly toxic (18)(19)(20). Compared to the above mentioned trial, toxicity in the present study was enhanced by methotrexate and probably by a generally lower renal clearance.…”

Gemcitabine and mitoxantrone in metastatic breast cancer: A phase-I-study

“…Although mitoxantrone and anthracyclines are structurally and biologically related, there is only incomplete cross resistance between the agents. Mitoxantrone has shown response rates between 30 and 36% in first-line chemotherapy [20][21][22] and up to 20% in the second line setting [23]. Mitoxantrone is generally well tolerated, with low emetogenic potential and mucosal toxicity and mild degree of alopecia.…”

Does induction chemotherapy with a mitoxantrone/vinorelbine regimen allow a breast-conservative treatment in patients with operable locoregional breast cancer?

“…The antitumor activity of this compound has been noted in leukemias, lymphomas, and breast cancers [12]. In advanced breast cancer, the RR to DHAD as a single agent ranges between 23 and 35% in patients without prior chemotherapy [13][14][15][16], and between 14 and 21% in those with prior chemotherapy but no previous exposure to doxorubicin [17][18][19]. Only 1 randomized study [17] out of 3 [17][18][19] has shown significantly higher RR with doxorubicin when compared to DHAD.…”