Phase I trial of pegylated liposomal doxorubicin and docetaxel in advanced breast cancer

Joseph A. Sparano, U. Malik, Lakshmi Rajdev, C. Sarta, U. Hopkins, A. C. Wolff

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

Purpose: To develop a combination of pegylated liposomal doxorubicin (Doxil; Alza Pharmaceuticals, Palo Alto, CA) and docetaxel (Taxotere; Aventis Pharmaceutical, Parsipanny, NJ) that can be safely used for the treatment of advanced breast cancer. Patients and Methods: Forty-one patients with locally advanced (n = 10) or metastatic (n = 31) breast cancer received Doxil (30-, 40-, or 45-mg/m2 intravenous [IV] infusion over 30 to 60 minutes), followed 1 hour later by docetaxel (60 or 75 mg/m2 by IV infusion over 1 hour) in cohorts of three to six patients. Dose-limiting toxicity (DLT) was defined as febrile neutropenia, prolonged neutropenia, or grade 3 to 4 nonhematologic toxicity that occurred during cycle 1. Results: In conjunction with docetaxel 75 mg/m2 every 4 weeks, the MTD of Doxil was 30 mg/m2 and required granulocyte colony-stimulating factor (G-CSF) to prevent febrile neutropenia. Without G-CSF, the MTD was docetaxel 60 mg/m2 and Doxil 30 mg/m2 every 3 weeks; only 1 (7%) out of 15 patients treated at this dose level had cycle 1 DLT. Infusion reactions were common with Doxil with the recommended infusion schedule during the first cycle (55%) but were reduced with a modified schedule (7%). There was no clinically significant cardiac toxicity. Objective response occurred in eight of nine assessable patients with stage III disease and in 16 (52%) of 31 patients (95% confidence interval, 34% to 70%) with stage IV disease. Conclusion: The recommended dose and schedule of this combination for further evaluation is Doxil 30 mg/m2 and docetaxel 60 mg/m2 given every 3 weeks without G-CSF. When used with G-CSF, it is Doxil 30 mg/m2 and docetaxel 75 mg/m2 every 4 weeks.

Original languageEnglish (US)
Pages (from-to)3117-3125
Number of pages9
JournalJournal of Clinical Oncology
Volume19
Issue number12
StatePublished - Jun 15 2001

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docetaxel
Breast Neoplasms
Granulocyte Colony-Stimulating Factor
Febrile Neutropenia
Appointments and Schedules
Intravenous Infusions
liposomal doxorubicin
Neutropenia
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Phase I trial of pegylated liposomal doxorubicin and docetaxel in advanced breast cancer. / Sparano, Joseph A.; Malik, U.; Rajdev, Lakshmi; Sarta, C.; Hopkins, U.; Wolff, A. C.

In: Journal of Clinical Oncology, Vol. 19, No. 12, 15.06.2001, p. 3117-3125.

Research output: Contribution to journalArticle

Sparano, Joseph A. ; Malik, U. ; Rajdev, Lakshmi ; Sarta, C. ; Hopkins, U. ; Wolff, A. C. / Phase I trial of pegylated liposomal doxorubicin and docetaxel in advanced breast cancer. In: Journal of Clinical Oncology. 2001 ; Vol. 19, No. 12. pp. 3117-3125.
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abstract = "Purpose: To develop a combination of pegylated liposomal doxorubicin (Doxil; Alza Pharmaceuticals, Palo Alto, CA) and docetaxel (Taxotere; Aventis Pharmaceutical, Parsipanny, NJ) that can be safely used for the treatment of advanced breast cancer. Patients and Methods: Forty-one patients with locally advanced (n = 10) or metastatic (n = 31) breast cancer received Doxil (30-, 40-, or 45-mg/m2 intravenous [IV] infusion over 30 to 60 minutes), followed 1 hour later by docetaxel (60 or 75 mg/m2 by IV infusion over 1 hour) in cohorts of three to six patients. Dose-limiting toxicity (DLT) was defined as febrile neutropenia, prolonged neutropenia, or grade 3 to 4 nonhematologic toxicity that occurred during cycle 1. Results: In conjunction with docetaxel 75 mg/m2 every 4 weeks, the MTD of Doxil was 30 mg/m2 and required granulocyte colony-stimulating factor (G-CSF) to prevent febrile neutropenia. Without G-CSF, the MTD was docetaxel 60 mg/m2 and Doxil 30 mg/m2 every 3 weeks; only 1 (7{\%}) out of 15 patients treated at this dose level had cycle 1 DLT. Infusion reactions were common with Doxil with the recommended infusion schedule during the first cycle (55{\%}) but were reduced with a modified schedule (7{\%}). There was no clinically significant cardiac toxicity. Objective response occurred in eight of nine assessable patients with stage III disease and in 16 (52{\%}) of 31 patients (95{\%} confidence interval, 34{\%} to 70{\%}) with stage IV disease. Conclusion: The recommended dose and schedule of this combination for further evaluation is Doxil 30 mg/m2 and docetaxel 60 mg/m2 given every 3 weeks without G-CSF. When used with G-CSF, it is Doxil 30 mg/m2 and docetaxel 75 mg/m2 every 4 weeks.",
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