Reactions 441 - 6 Mar 1993

SAntineoplastics

Non-haematological toxicity with sequential high-dose regimens: clinical study

Serious, sometimes fatal, nonhaematological toxicity is alimiting factor in the use of sequential high-dose antineoplasticregimens for the treatment of advanced breast cancer, reportAustralian researchers. They report a study of 15 patients withrelapsed or metastatic breast cancer who underwent suchtherapy. The programme consisted of: (A) Single high-dose IVcyclophosphamide (4 g/m sup(2)) followed by autologousperipheral blood stem cell (PBSC) collection (B) Three cycles ofconventional dose antineoplastic therapy with doxorubicin,fluorouracil and methotrexate administered every 3 weeks (C)IV cyclophosphamide 1.875 g/m sup(2)/day, cisplatin 55 mg/m sup(2)/day and carmustine 100mg/m sup(2) 12-hourly ondays 1-3 followed by PBSC rescue 24h later; and (D) IVetoposide 150 mg/m sup(2) 12-hourly on days 1-3, melphalan180 mg/m sup(2) on day 4 and PBSC rescue 24h later. Only 2patients completed the study and both died of severepneumonitis. After phase A, 9 patients developed febrileneutropenia, 1 died of septicaemia and 4 patients werewithdrawn because of progressive disease (n = 3) and/orinsufficient PBSC collection (2). Two further patients werewithdrawn during phase B due to progressive disease. Fourpatients entered phase C; 2 experienced severe GI and neuro/psychological toxicity and were withdrawn from the study atthis stage and the other 2 subsequently died after phase D; theremaining 4 patients who were eligible for phases C and Dwere treated with alternative antineoplastic regimens as thestudy was terminated early because of unacceptable toxicityPittman KB, et al. Non-haematological toxicity limiting the application ofsequential high dose chemotherapy in patients with advanced breast cancer. BoneMarrow Transplantation 10: 535-540, Dec 1992 - Australia 800180514

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Reactions 6 Mar 1993 No. 4410114-9954/10/0441-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved