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Single agent epirubicin as first line chemotherapy for metastatic breast cancer patients

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Abstract

In order to better explore the toxicity and the activity of high dose epirubicin (120 mg/m2, 3 weeks) we analyzed a population of 127 metastatic breast cancer patients, treated in a randomized clinical trial conducted to evaluate the cardioprotective effect of dexrazoxane against epirubicin induced cardiotoxicity. All the patients had a diagnosis of metastatic breast cancer, an ECOG performance status ≥2 and normal hematologic, renal, hepatic and cardiac function. No prior adjuvant chemotherapy including anthracycline was allowed. Epirubicin was given at the dose of 120 mg/m2 i.v. bolus every 3 weeks. One hundred twenty five patients were evaluable for toxicity and response. Seventeen patients (11%) had a complete response and 47 patients (37%) a partial response, for an overall response rate of 48%. The median progression free and overall survivals were 8.3 months and 18.3 months, respectively. Grade 3 and 4 leukopenia were observed in 8% and 7% of the patients, respectively. The most frequent nonhematological grade 3 toxicities were alopecia (87%), nausea and vomiting (16%), and mucositis (8%). Cardiotoxicity, defined as occurrence of congestive heart failure, decrease in resting left ventricular ejection fraction (L-VEF) to ≥45, or 20 EF units decrease from baseline L-VEF, was observed in 19% of the patients, after a median cumulative dose of epirubicin of 720 mg/m2 (range 120–1440). This study confirms in a large series of patients the activity of high dose epirubicin; however, the high incidence of cardiotoxicity requires a careful evaluation of cardiac risk factors before treatment.

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Authors and Affiliations

  1. U.O. Oncologia Medica, Dipartimento di Oncologia Ospedale S. Chiara, Pisa and G.O.N.O. (Gruppo Oncologico Nord Ovest) Centres, Istituto Nazionale per Ia Ricerca sul Cancro, Genova

    Andrea Michelotti, Carmelo Tibaldi, Carmelo Bengala, Lucia Del Mastro & Pierfranco Conte

  2. Divisione di Oncologia Medica I, Ospedale Galliera, Genova

    Marco Venturini & Riccardo Rosso

  3. Servizio di Oncologia Medica, Ospedale Galliera, Genova

    Luigi Gallo

  4. U.O. di Ginecologia C, Ospedale S. Anna, Torino, Italy

    Flavio Carnino

  5. Servizio di Epidemiologia Clinica e Sperimentazioni Cliniche Controllate, Ospedale Galliera, Genova

    Rita Lionetto & Elda Montanaro

Authors
  1. Andrea Michelotti
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  2. Marco Venturini
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  3. Carmelo Tibaldi
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  4. Carmelo Bengala
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  5. Luigi Gallo
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  6. Flavio Carnino
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  7. Lucia Del Mastro
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  8. Rita Lionetto
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  9. Elda Montanaro
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  10. Riccardo Rosso
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  11. Pierfranco Conte
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Michelotti, A., Venturini, M., Tibaldi, C. et al. Single agent epirubicin as first line chemotherapy for metastatic breast cancer patients. Breast Cancer Res Treat 59, 133–139 (2000). https://doi.org/10.1023/A:1006394801389

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