Combination chemotherapy with epirubicin and vinorelbine in metastatic breast cancer

ABSTRACT

Anthracyclines and vinorelbine have shown good response rates as single agent chemotherapy in metastatic breast cancer. A pahse I study has shown improved results by combining these two drugs. On the basis of this we carried out a phase II study in Oncology Department, Combined Military Hospital, Rawalpindi, in which the efficacy and side effects of epirubicin-vinorelbine as first-line chemotherapy in metastatic breast cancer evaluated. The purpose of this phase II study was to observe the effects of combination of epirubicin and vinorelbine in metastatic breast cancer as first-line chemotherapy in our population. From July 2000 to June 2001, chemo naive patients with metastatic breast cancer were given combination chemotherapy comprising epirubicin 100 mg/m2 i.v. infusion on day 1 and vinorelbine 25 mg/m2 i.v infusion on day 1 and 8. A total of six cycles were given to all patients with 3 weekly intervals. Patients with grade 3 and 4 neutropenia were also given G-CSF support. Seven out of 26 patients were pre menopausal and 73.07% were post menopausal. All patients had WHO performance status of > 3. Four [15.38%] out of 26 patients had complete response [CR] and 53.84% had partial response [PR] making and overall response of 69.22 and. Stable disease was observed in 5[19.23%] patients whereas 3 [11.53%] had progressive disease. Neutropenia was the most common side effect observed which was grade 4 in 6[23.07%] patients and grade 3 in 10 [38.46%] patients. Other side effects were mild to moderate. As first line chemotherapyv in treatment of metastatic breast cancer, the combination of epirubicin and vinorelbine is an active and cost effective regimen, with less side effects and excellent tolerability