Journal of B.U.ON., cilt.4, sa.3, ss.275-281, 1999 (SCI-Expanded)
Purpose: To evaluate the efficacy and safety of paclitaxel in the salvage treatment of metastatic breast carcinoma (MBC). Patients and methods: 29 female patients (median age 45 years, range 30-66 years) with anthracycline-resistant or heavily pretreated MBC entered the study. Twenty patients had multiple metastases and 14 had received more than one prior chemotherapy regimen. Paclitaxel 135 mg/m2 was administered as a 24-hour infusion after standard premedication, every 3 weeks. Results: A median of 5 cycles (range 2-9) were administered. The median follow-up period was 9 months (range 2-17 months). Eight (27.6%) patients showed partial response (PR), 12 stable disease (SD), and 9 progressive disease (PD). The overall response rate was 27.6%. Six of 8 (75%) patients with PR had soft-tissue metastases and the remaining 2 (25%) had visceral metastases. Fifty percent of patients with soft-tissue metastases responded to treatment. Response rate was significantly higher in anthracycline-sensitive than in anthracycline-resistant patients (54.5% versus 11%, p=0.02809). The median response duration was 4 months (range 3-10 months), the median time to tumor progression (TTP) 5 months (range 2-11+ months), and the median survival 11 months (range 2-17 months) with no difference between responders and nonresponders. Alopecia (100%), neutropenia (48%) and fatigue (38%) were the major side effects. Hypersensitivity reactions and severe edema were not observed. Conclusion: Paclitaxel is a safe drug and particularly effective in soft tissue metastases in heavily pretreated MBC patients. However, because response rate and response duration were not higher than other salvage treatments, cost-benefit considerations should be taken into account before starting a salvage treatment.