MITOXANTRONE, VINCRISTINE, AND 5-FLUOROURACIL WITH LEUCOVORIN MODULATION AS INDUCTION CHEMOTHERAPY PRIOR TO HIGH-DOSE INTENSIFICATION IN METASTATIC BREAST-CANCER
Sf. Williams et al., MITOXANTRONE, VINCRISTINE, AND 5-FLUOROURACIL WITH LEUCOVORIN MODULATION AS INDUCTION CHEMOTHERAPY PRIOR TO HIGH-DOSE INTENSIFICATION IN METASTATIC BREAST-CANCER, Breast cancer research and treatment, 28(3), 1993, pp. 291-294
We treated 39 women with newly diagnosed stage IV breast cancer with a
new regimen of mitoxantrone 18 mg/m(2) on days 1, 29, 57, vincristine
1.4 mg/m(2) (maximum 2.0 mg) on days 1, 8, 15, 22, 29, 36, 43, 50, an
d 5-fluorouracil 375 mg/m(2) on days 15-20, 43-47, 71-75 with leucovor
in modulation 500 mg/m(2) before each 5FU infusion (MVF). This regimen
was utilized as an initial cytoreductive or induction program for the
se patients prior to high-dose intensification with autologous stem ce
ll rescue. Ten patients (25%) obtained a clinical complete response an
d six patients (15%) obtained a partial response for an overall respon
se rate of 40%. In addition, 10 patients had evaluable disease that wa
s improved or stable (primarily bone and/or bone marrow metastases) af
ter MVF induction. Thus, 26 patients (65%) were eligible for high-dose
intensification with autologous stem cell rescue after MVF induction.
Toxicity was primarily a mild mucositis and more commonly peripheral
neuropathy. MVF therapy is an active treatment program for metastatic
breast cancer but the neurotoxicity makes it difficult to recommend fo
r widespread use.