PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of bmccancBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Cancer
 
BMC Cancer. 2012; 12: 165.
Published online 2012 May 4. doi:  10.1186/1471-2407-12-165
PMCID: PMC3443018
Weekly paclitaxel plus trastuzumab in metastatic breast cancer pretreated with anthracyclines-a phase II multipractice study
Matthias John,corresponding author1 Axel Hinke,2 Martina Stauch,3 Heiner Wolf,4 Benno Mohr,5 Hans-Joachim Hindenburg,6 Jens Papke,7 and Joachim Schlosser8, for the FAKT Study Group
1Practice for Gynecology, Dr.-Doerffel-Strasse 1, 08371, Glauchau, Germany
2WiSP Research Institute, Karl-Benz-Str. 1, 40764, Langenfeld, Germany
3Practice for Medical Oncology, Niederbonner Arnoldstrasse 2, 96317, Kronach, Germany
4Practice for Medical Oncology, Arnoldstrasse 18, 01307, Dresden, Germany
5Practice for Medical Oncology, Breite Strasse 52, 13597, Berlin, Germany
6Practice for Medical Oncology, Pichelsdorfer Str. 105, 13595, Berlin, Germany
7Praxis for Medical Oncology, Rosa-Luxemburg-Strasse 6, 01844, Neustadt/Sachsen, Germany
8Practice for Gynecology, Clausstrasse 76-80, 09126, Chemnitz, Germany
corresponding authorCorresponding author.
Matthias John: dr.matthias.john/at/web.de; Axel Hinke: axel.hinke/at/wisp.de; Martina Stauch: studien/at/drstauch.de; Heiner Wolf: hewolf/at/dgn.de; Benno Mohr: info/at/atzs.de; Hans-Joachim Hindenburg: dr.hindenburg/at/gmx.de; Jens Papke: mail/at/drpapke.de; Joachim Schlosser: dr.j.schlosser/at/t-online.de
Received August 17, 2011; Accepted March 12, 2012.
Abstract
Background
The 3-weekly combination of trastuzumab and paclitaxel has been approved for the treatment of advanced breast cancer based on a large pivotal study. However, mono and combination chemotherapy trials suggest that weekly paclitaxel has a better therapeutic index, especially in the palliative setting. The present trial examined the efficacy and safety of weekly paclitaxel over a limited duration combined with continued trastuzumab in HER2+ patients.
Methods
Patients with histologically confirmed metastatic breast cancer overexpressing HER2 were eligible if pretreated with anthracycline in either the adjuvant or palliative setting. Treatment consisted of weekly trastuzumab (2 mg/kg/week for up to one year after a loading dose of 4 mg/kg in week 1) and paclitaxel (90 mg/m², administered in weeks 1–6 and 8–13).
Results
Twenty-seven German centers enrolled 121 patients. The median number of metastatic sites was two (range 1–5); 38% of patients had received chemotherapy for advanced disease. After a median 42 weeks of trastuzumab treatment, limited by disease progression in roughly half the patients, a best objective response rate (complete response + partial response) of 76% was achieved, including complete remissions in 29%. 74% of patients lived without tumor progression at six months. Median progression-free and overall survival were 9.4 (95% confidence interval [CI]: 8.1–11.3) and 22 months (95% CI: 17–46). After alopecia, Common Toxicity Criteria grade ≥2 toxicity was predominantly hematological (leukopenia [31%] and anemia [41%]); however, thrombocytopenia occurred in only 5%. Neurotoxicity was remarkably low. Two cardiac events (grades 2 and 3) were presumed treatment-related.
Conclusions
Weekly paclitaxel plus trastuzumab allows an increased dose density and offers an attractive and effective alternative to the conventional schedule. Limiting the duration of cytotoxic therapy to 3 months seems to be an option to reduce neurotoxicity without impairing long-term outcome.
Articles from BMC Cancer are provided here courtesy of
BioMed Central