Phase II study of mitoxantrone by 14-day continuous infusion with granulocyte colony stimulating factor (GCSF) support in patients with metastatic breast cancer and limited prior therapy
L. Pusztai et al., Phase II study of mitoxantrone by 14-day continuous infusion with granulocyte colony stimulating factor (GCSF) support in patients with metastatic breast cancer and limited prior therapy, CANC CHEMOT, 43(1), 1999, pp. 86-91
Purpose: Early phase II evaluation of intravenous bolus mitoxantrone indica
ted objective response rates of 17-36% in patients with metastatic breast c
ancer. Subsequently, it has been suggested that continuous infusion may be
the optimal way to administer this drug in order to achieve maximal cytotox
ic effect with minimal toxicity. We present the results of a phase II study
that evaluated the efficacy and side effects of mitoxantrone administered
at the maximally tolerated dose by continuous infusion in patients with met
astatic breast cancer. Methods: This study included 16 patients with metast
atic breast cancer and limited previous therapy for their metastatic diseas
e. Mitoxantrone, 1.5 mg/m(2) per day, was given by continuous intravenous i
nfusion for 14 consecutive days repeated every 21 days with. concomitant gr
anulocyte colony-stimulating factor support. Dose escalation was allowed. R
esults: No complete tumor response was seen. Two patients (13%, CI 0-39%) h
ad a partial response, nine patients (56%) had progressive disease and the
remaining five patients (31%) had stable disease on therapy. The major dose
-limiting side effect was myelotoxicity. Two of the 16 patients (13%) exper
ienced asymptomatic cardiotoxicity that required discontinuation of therapy
. Conclusions: Our results indicate limited antitumor activity and signific
ant toxicity of mitoxantrone given by continuous infusion as second-line ch
emotherapy for metastatic breast cancer. The objective response rate docume
nted in this study is inferior to response rates reported with other second
-line regimens, particularly the taxanes, now available for this patient po
pulation.