EPIRUBICIN HAS MODEST SINGLE-AGENT ACTIVITY IN HEAD AND NECK-CANCER BUT LIMITED ACTIVITY IN METASTATIC MELANOMA AND COLORECTAL-CANCER - PHASE-II STUDIES BY THE EASTERN-COOPERATIVE-ONCOLOGY-GROUP
Ma. Rosenthal et al., EPIRUBICIN HAS MODEST SINGLE-AGENT ACTIVITY IN HEAD AND NECK-CANCER BUT LIMITED ACTIVITY IN METASTATIC MELANOMA AND COLORECTAL-CANCER - PHASE-II STUDIES BY THE EASTERN-COOPERATIVE-ONCOLOGY-GROUP, American journal of clinical oncology, 21(5), 1998, pp. 509-512
Epirubicin (4'-epidoxorubicin), a diastereoisomer of doxorubicin, has
established activity in the treatment of many cancer types sensitive t
o doxorubicin. Its activity in other tumor targets such as melanoma, h
ead and neck cancer, and recurrent colorectal cancer has been less wel
l defined. Three concurrent phase IT studies examined the efficacy and
toxicity of epirubicin (90 mg/m(2) given intravenously at 3-week inte
rvals) in the treatment of 71 patients with the aforementioned cancers
. Of 66 eligible patients who were assessable for response, one patien
t (with colorectal cancer) achieved a complete response and three pati
ents (with head and neck cancer) achieved partial responses. The respo
nse rate in patients with head and neck cancer was 18% (95% confidence
interval, 4-43%). Myelosuppression, alopecia, and nausea were the mos
t frequent toxicities. Two patients died of neutropenic sepsis and gra
de IV leukopenia occurred in six patients (8%). Grade In toxicities we
re as follows: leukopenia (17%), anemia (10%), alopecia (8%), fever (1
%), thrombocytopenia (1%). Grade I or II cardiac toxicity was noted in
four patients at cumulative doses ranging between 375 mg/m(2) to 1,28
3 mg/m(2). Epirubicin is ineffective as a single agent at this dose an
d schedule in the treatment of patients with melanoma and colorectal c
ancer. In head and neck cancer, a modest response rate encourages furt
her exploration of epirubicin and related anthracyclines in combinatio
n regimens.