SALVAGE CHEMOTHERAPY WITH PACLITAXEL, VINORELBINE, AND CISPLATIN (PVC) IN ANTHRACYCLINE-RESISTANT ADVANCED BREAST-CANCER

The tolerance and the efficacy of the paclitaxel-vinorelbine-cisplatin combination (PVC regimen) was evaluated in 33 patients with anthracyc line-resistant stage TV breast cancer, who had disease progression und er anthracycline- or mitoxantrone-based chemotherapy. Fourteen (42%) a nd 19 (5S%) patients had primary and secondary resistance to anthracyc lines, respectively; 70% had visceral metastases. Patients received vi norelbine (25 mg/m(2)) followed by paclitaxel (135 mg/m(2)) in a 3-hou r infusion on day 1, and cisplatin (CDDP; 80 mg/m(2)) on day 2, in a 3 -week schedule. A total of 208 chemotherapy courses were administered (median six courses per patient). Grade 3/4 neutropenia occurred in 13 patients (39%), seven of whom were hospitalized for neutropenic fever (5% of the courses). There was no toxic death, Grade 4 thrombocytopen ia occurred in two patients (6%) and grade 3 anemia in three patients (6%). Grade 2 and 3 neurosensory toxicity occurred in 11 patients (32% ) and two patients (6%), respectively, and grade 3/4 fatigue was obser ved in four patients (12%). Two (6%) complete and 17 partial responses (52%) (total, 58%; 95% confidence interval, 42%-75%) were documented. Stable disease was observed in eight patients (24%) and progression i n six patients (18%). The median duration of response was 6.5+ months. The median survival was 15+ months, and the I-year survival was 67%. In conclusion, PVC regimen is an active and well-tolerated salvage che motherapy in patients resistant to anthracycline.