Pegylated liposomal doxorubicin plus docetaxel significantly improves time to progression without additive cardiotoxicity compared with docetaxel monotherapy in patients with advanced breast cancer previously treated with neoadjuvant-adjuvant anthracycline therapy: Results from a randomized phase III study

Joseph A. Sparano, Anatoly N. Makhson, Vladimir F. Semiglazov, Sergei A. Tjulandin, Olga I. Balashova, Igor N. Bondarenko, Natalia V. Bogdanova, George M. Manikhas, Gennadiy P. Oliynychenko, Valery A. Chatikhine, Sen H. Zhuang, Liang Xiu, Zhilong Yuan, Wayne R. Rackoff

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Abstract

Purpose: To determine whether the combination of pegylated liposomal doxorubicin (PLD) and docetaxel significantly prolongs time to disease progression compared with docetaxel alone without an increase in cardiac toxicity in women with advanced breast cancer who had experienced relapse at least 1 year after prior adjuvant or neoadjuvant anthracycline therapy. Patients and Methods: This international, phase III study randomly assigned 751 patients to receive either docetaxel 75 mg/m2 (n = 373) or PLD 30 mg/m 2 followed by docetaxel 60 mg/m2 every 21 days (n = 378) and continued until disease progression or prohibitive toxicity. The primary end point was time to progression (TTP). Secondary end points were overall survival (OS), objective response rate (ORR), cardiac toxicity, and safety. Results: Treatment with PLD-docetaxel significantly improved median TTP from 7.0 to 9.8 months (hazard ratio [HR] = 0.65; 95% CI, 0.55 to 0.77; P = .000001) and the ORR from 26% to 35% (P = .0085). OS was similar between the two groups (HR = 1.02; 95% CI, 0.86 to 1.22). The incidence of grade 3 or 4 adverse events were similar (78% v 72%), although a higher incidence of hand-foot syndrome (24% v 0%) and mucositis/stomatitis (12% v 1%) were observed in the PLD-docetaxel combination. Protocol-defined left ventricular ejection fraction decreases and congestive heart failure were reported in 5% and 1% in both treatment arms, respectively. Conclusion: The PLD-docetaxel combination was more effective than docetaxel alone in women with metastatic breast cancer who had experienced relapse at least 1 year after prior adjuvant anthracycline therapy without an increase in cardiac toxicity, although mucocutaneous toxicity was more common.

Original languageEnglish (US)
Pages (from-to)4522-4529
Number of pages8
JournalJournal of Clinical Oncology
Volume27
Issue number27
DOIs
StatePublished - Sep 20 2009
Externally publishedYes

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docetaxel
Anthracyclines
Breast Neoplasms
Therapeutics
Disease Progression
Hand-Foot Syndrome
Recurrence
Stomatitis
Mucositis
Neoadjuvant Therapy
Survival
Cardiotoxicity
liposomal doxorubicin
Incidence
Stroke Volume

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Pegylated liposomal doxorubicin plus docetaxel significantly improves time to progression without additive cardiotoxicity compared with docetaxel monotherapy in patients with advanced breast cancer previously treated with neoadjuvant-adjuvant anthracycline therapy : Results from a randomized phase III study. / Sparano, Joseph A.; Makhson, Anatoly N.; Semiglazov, Vladimir F.; Tjulandin, Sergei A.; Balashova, Olga I.; Bondarenko, Igor N.; Bogdanova, Natalia V.; Manikhas, George M.; Oliynychenko, Gennadiy P.; Chatikhine, Valery A.; Zhuang, Sen H.; Xiu, Liang; Yuan, Zhilong; Rackoff, Wayne R.

In: Journal of Clinical Oncology, Vol. 27, No. 27, 20.09.2009, p. 4522-4529.

Research output: Contribution to journalArticle

Sparano, Joseph A. ; Makhson, Anatoly N. ; Semiglazov, Vladimir F. ; Tjulandin, Sergei A. ; Balashova, Olga I. ; Bondarenko, Igor N. ; Bogdanova, Natalia V. ; Manikhas, George M. ; Oliynychenko, Gennadiy P. ; Chatikhine, Valery A. ; Zhuang, Sen H. ; Xiu, Liang ; Yuan, Zhilong ; Rackoff, Wayne R. / Pegylated liposomal doxorubicin plus docetaxel significantly improves time to progression without additive cardiotoxicity compared with docetaxel monotherapy in patients with advanced breast cancer previously treated with neoadjuvant-adjuvant anthracycline therapy : Results from a randomized phase III study. In: Journal of Clinical Oncology. 2009 ; Vol. 27, No. 27. pp. 4522-4529.
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title = "Pegylated liposomal doxorubicin plus docetaxel significantly improves time to progression without additive cardiotoxicity compared with docetaxel monotherapy in patients with advanced breast cancer previously treated with neoadjuvant-adjuvant anthracycline therapy: Results from a randomized phase III study",
abstract = "Purpose: To determine whether the combination of pegylated liposomal doxorubicin (PLD) and docetaxel significantly prolongs time to disease progression compared with docetaxel alone without an increase in cardiac toxicity in women with advanced breast cancer who had experienced relapse at least 1 year after prior adjuvant or neoadjuvant anthracycline therapy. Patients and Methods: This international, phase III study randomly assigned 751 patients to receive either docetaxel 75 mg/m2 (n = 373) or PLD 30 mg/m 2 followed by docetaxel 60 mg/m2 every 21 days (n = 378) and continued until disease progression or prohibitive toxicity. The primary end point was time to progression (TTP). Secondary end points were overall survival (OS), objective response rate (ORR), cardiac toxicity, and safety. Results: Treatment with PLD-docetaxel significantly improved median TTP from 7.0 to 9.8 months (hazard ratio [HR] = 0.65; 95{\%} CI, 0.55 to 0.77; P = .000001) and the ORR from 26{\%} to 35{\%} (P = .0085). OS was similar between the two groups (HR = 1.02; 95{\%} CI, 0.86 to 1.22). The incidence of grade 3 or 4 adverse events were similar (78{\%} v 72{\%}), although a higher incidence of hand-foot syndrome (24{\%} v 0{\%}) and mucositis/stomatitis (12{\%} v 1{\%}) were observed in the PLD-docetaxel combination. Protocol-defined left ventricular ejection fraction decreases and congestive heart failure were reported in 5{\%} and 1{\%} in both treatment arms, respectively. Conclusion: The PLD-docetaxel combination was more effective than docetaxel alone in women with metastatic breast cancer who had experienced relapse at least 1 year after prior adjuvant anthracycline therapy without an increase in cardiac toxicity, although mucocutaneous toxicity was more common.",
author = "Sparano, {Joseph A.} and Makhson, {Anatoly N.} and Semiglazov, {Vladimir F.} and Tjulandin, {Sergei A.} and Balashova, {Olga I.} and Bondarenko, {Igor N.} and Bogdanova, {Natalia V.} and Manikhas, {George M.} and Oliynychenko, {Gennadiy P.} and Chatikhine, {Valery A.} and Zhuang, {Sen H.} and Liang Xiu and Zhilong Yuan and Rackoff, {Wayne R.}",
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TY - JOUR

T1 - Pegylated liposomal doxorubicin plus docetaxel significantly improves time to progression without additive cardiotoxicity compared with docetaxel monotherapy in patients with advanced breast cancer previously treated with neoadjuvant-adjuvant anthracycline therapy

T2 - Results from a randomized phase III study

AU - Sparano, Joseph A.

AU - Makhson, Anatoly N.

AU - Semiglazov, Vladimir F.

AU - Tjulandin, Sergei A.

AU - Balashova, Olga I.

AU - Bondarenko, Igor N.

AU - Bogdanova, Natalia V.

AU - Manikhas, George M.

AU - Oliynychenko, Gennadiy P.

AU - Chatikhine, Valery A.

AU - Zhuang, Sen H.

AU - Xiu, Liang

AU - Yuan, Zhilong

AU - Rackoff, Wayne R.

PY - 2009/9/20

Y1 - 2009/9/20

N2 - Purpose: To determine whether the combination of pegylated liposomal doxorubicin (PLD) and docetaxel significantly prolongs time to disease progression compared with docetaxel alone without an increase in cardiac toxicity in women with advanced breast cancer who had experienced relapse at least 1 year after prior adjuvant or neoadjuvant anthracycline therapy. Patients and Methods: This international, phase III study randomly assigned 751 patients to receive either docetaxel 75 mg/m2 (n = 373) or PLD 30 mg/m 2 followed by docetaxel 60 mg/m2 every 21 days (n = 378) and continued until disease progression or prohibitive toxicity. The primary end point was time to progression (TTP). Secondary end points were overall survival (OS), objective response rate (ORR), cardiac toxicity, and safety. Results: Treatment with PLD-docetaxel significantly improved median TTP from 7.0 to 9.8 months (hazard ratio [HR] = 0.65; 95% CI, 0.55 to 0.77; P = .000001) and the ORR from 26% to 35% (P = .0085). OS was similar between the two groups (HR = 1.02; 95% CI, 0.86 to 1.22). The incidence of grade 3 or 4 adverse events were similar (78% v 72%), although a higher incidence of hand-foot syndrome (24% v 0%) and mucositis/stomatitis (12% v 1%) were observed in the PLD-docetaxel combination. Protocol-defined left ventricular ejection fraction decreases and congestive heart failure were reported in 5% and 1% in both treatment arms, respectively. Conclusion: The PLD-docetaxel combination was more effective than docetaxel alone in women with metastatic breast cancer who had experienced relapse at least 1 year after prior adjuvant anthracycline therapy without an increase in cardiac toxicity, although mucocutaneous toxicity was more common.

AB - Purpose: To determine whether the combination of pegylated liposomal doxorubicin (PLD) and docetaxel significantly prolongs time to disease progression compared with docetaxel alone without an increase in cardiac toxicity in women with advanced breast cancer who had experienced relapse at least 1 year after prior adjuvant or neoadjuvant anthracycline therapy. Patients and Methods: This international, phase III study randomly assigned 751 patients to receive either docetaxel 75 mg/m2 (n = 373) or PLD 30 mg/m 2 followed by docetaxel 60 mg/m2 every 21 days (n = 378) and continued until disease progression or prohibitive toxicity. The primary end point was time to progression (TTP). Secondary end points were overall survival (OS), objective response rate (ORR), cardiac toxicity, and safety. Results: Treatment with PLD-docetaxel significantly improved median TTP from 7.0 to 9.8 months (hazard ratio [HR] = 0.65; 95% CI, 0.55 to 0.77; P = .000001) and the ORR from 26% to 35% (P = .0085). OS was similar between the two groups (HR = 1.02; 95% CI, 0.86 to 1.22). The incidence of grade 3 or 4 adverse events were similar (78% v 72%), although a higher incidence of hand-foot syndrome (24% v 0%) and mucositis/stomatitis (12% v 1%) were observed in the PLD-docetaxel combination. Protocol-defined left ventricular ejection fraction decreases and congestive heart failure were reported in 5% and 1% in both treatment arms, respectively. Conclusion: The PLD-docetaxel combination was more effective than docetaxel alone in women with metastatic breast cancer who had experienced relapse at least 1 year after prior adjuvant anthracycline therapy without an increase in cardiac toxicity, although mucocutaneous toxicity was more common.

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