Dose-dense epirubicin and paclitaxel with G-CSF: a study of decreasing intervals in metastatic breast cancer

Anthracyclines and taxanes are very effective drugs in the treatment of adv anced breast cancer. With G-CSF support, the dose-intensity of this combina tion can be increased by reducing the interval between chemotherapy cycles, the so-called 'shortening of cycle time'. We treated 36 patients with adva nced breast cancer in a multicentre phase I/II study. The treatment regimen consisted of epirubicin 75 mg m(-2) followed by paclitaxel 135 mg m(-2) (3 h) in combination with G-CSF. At least six patients were treated in each c ohort and were evaluated over the first three cycles. Starting at an interv al of 14 days, in subsequent cohorts of patients the interval could be shor tened to 10 days. An 8-day interval was not feasible due mainly to incomple te neutrophil recovery at the day of the next scheduled cycle. In the 10-da y interval cohort it was feasible to increase the paclitaxel dose to 175 mg m(-2). The haematological and non-haematological toxicity was relatively m ild. No cumulative myelosuppression was observed over at least three consec utive cycles. In combination with G-CSF, epirubicin 75 mg m(-2) and paclita xel 175 mg m(-2) could be safely administered every 10 days over at least t hree cycles, enabling a dose intensity of 52 and 122 mg m(-2) per week, res pectively. (C) 2000 Cancer Research Campaign.