A pilot study of dose intense doxorubicin and cyclophosphamide followed by infusional paclitaxel in high-risk primary breast cancer

Jo Anne Zujewski, Jennifer Eng-Wong, Joyce O'Shaughnessy, David Venzon, Catherine Chow, David Danforth, David R. Kohler, Georgia Cusack, David Riseberg, Kenneth H. Cowan

Research output: Contribution to journalArticle

Abstract

We conducted a pilot study of dose dense doxorubicin and cyclophosphamide (AC) combination chemotherapy followed by infusional paclitaxel (T) in primary breast cancer to determine its safety and feasibility. Twenty-two subjects (10 with stage II and ≥4 positive lymph nodes, and 12 with stage III disease) were treated with AC (A 60 mg/m2 and C 2000 mg/m2) with filgrastim every 14 days for three cycles followed by infusional paclitaxel (140 mg/m2 over 96 h) every 14 days for three cycles. Mean overall cycle length was 15.3 days and mean duration of therapy was 92 days. Dose reductions of C or T were required in 7/132 (5.3%) cycles for mucositis, diarrhea, or failure to recover platelets by day 15. Ninety-five percent of subjects had grade 4 neutropenia and 1 subject had a platelet nadir of <20,000. Actual delivered dose intensity (DI) over six cycles was: A 27 mg/m2 per week; C 892 mg/m2 per week; T 64 mg/m 2 per week (90.6, 89.2, and 91.4% of planned DI, respectively). Average total dose administered was: A 180 mg/m2; C 5880 mg/m 2; T 403 mg/m2 (100, 98, and 96% of planned total doses, respectively). Clinical response rate in 10 subjects receiving neoadjuvant therapy was 100% (4 complete response, 6 partial response). Four subjects had a pathologic complete response (three subjects without evidence of malignancy and one subject with ductal carcinoma in situ.) Administration of dose dense AC followed by infusional paclitaxel in 14-day cycles is feasible and this regimen is active in breast cancer.

Original languageEnglish (US)
Pages (from-to)41-51
Number of pages11
JournalBreast Cancer Research and Treatment
Volume81
Issue number1
DOIs
StatePublished - Sep 2003
Externally publishedYes

Fingerprint

Paclitaxel
Doxorubicin
Cyclophosphamide
Breast Neoplasms
Blood Platelets
Mucositis
Carcinoma, Intraductal, Noninfiltrating
Neoadjuvant Therapy
Combination Drug Therapy
Neutropenia
Diarrhea
Lymph Nodes
Safety
Neoplasms
Therapeutics

Keywords

  • Breast cancer
  • Dose dense chemotherapy
  • Neoadjuvant chemotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

A pilot study of dose intense doxorubicin and cyclophosphamide followed by infusional paclitaxel in high-risk primary breast cancer. / Zujewski, Jo Anne; Eng-Wong, Jennifer; O'Shaughnessy, Joyce; Venzon, David; Chow, Catherine; Danforth, David; Kohler, David R.; Cusack, Georgia; Riseberg, David; Cowan, Kenneth H.

In: Breast Cancer Research and Treatment, Vol. 81, No. 1, 09.2003, p. 41-51.

Research output: Contribution to journalArticle

Zujewski, JA, Eng-Wong, J, O'Shaughnessy, J, Venzon, D, Chow, C, Danforth, D, Kohler, DR, Cusack, G, Riseberg, D & Cowan, KH 2003, 'A pilot study of dose intense doxorubicin and cyclophosphamide followed by infusional paclitaxel in high-risk primary breast cancer', Breast Cancer Research and Treatment, vol. 81, no. 1, pp. 41-51. https://doi.org/10.1023/A:1025421416674
Zujewski, Jo Anne ; Eng-Wong, Jennifer ; O'Shaughnessy, Joyce ; Venzon, David ; Chow, Catherine ; Danforth, David ; Kohler, David R. ; Cusack, Georgia ; Riseberg, David ; Cowan, Kenneth H. / A pilot study of dose intense doxorubicin and cyclophosphamide followed by infusional paclitaxel in high-risk primary breast cancer. In: Breast Cancer Research and Treatment. 2003 ; Vol. 81, No. 1. pp. 41-51.
@article{7bc2a1045e654b4ea84135a6fa440a47,
title = "A pilot study of dose intense doxorubicin and cyclophosphamide followed by infusional paclitaxel in high-risk primary breast cancer",
abstract = "We conducted a pilot study of dose dense doxorubicin and cyclophosphamide (AC) combination chemotherapy followed by infusional paclitaxel (T) in primary breast cancer to determine its safety and feasibility. Twenty-two subjects (10 with stage II and ≥4 positive lymph nodes, and 12 with stage III disease) were treated with AC (A 60 mg/m2 and C 2000 mg/m2) with filgrastim every 14 days for three cycles followed by infusional paclitaxel (140 mg/m2 over 96 h) every 14 days for three cycles. Mean overall cycle length was 15.3 days and mean duration of therapy was 92 days. Dose reductions of C or T were required in 7/132 (5.3{\%}) cycles for mucositis, diarrhea, or failure to recover platelets by day 15. Ninety-five percent of subjects had grade 4 neutropenia and 1 subject had a platelet nadir of <20,000. Actual delivered dose intensity (DI) over six cycles was: A 27 mg/m2 per week; C 892 mg/m2 per week; T 64 mg/m 2 per week (90.6, 89.2, and 91.4{\%} of planned DI, respectively). Average total dose administered was: A 180 mg/m2; C 5880 mg/m 2; T 403 mg/m2 (100, 98, and 96{\%} of planned total doses, respectively). Clinical response rate in 10 subjects receiving neoadjuvant therapy was 100{\%} (4 complete response, 6 partial response). Four subjects had a pathologic complete response (three subjects without evidence of malignancy and one subject with ductal carcinoma in situ.) Administration of dose dense AC followed by infusional paclitaxel in 14-day cycles is feasible and this regimen is active in breast cancer.",
keywords = "Breast cancer, Dose dense chemotherapy, Neoadjuvant chemotherapy",
author = "Zujewski, {Jo Anne} and Jennifer Eng-Wong and Joyce O'Shaughnessy and David Venzon and Catherine Chow and David Danforth and Kohler, {David R.} and Georgia Cusack and David Riseberg and Cowan, {Kenneth H.}",
year = "2003",
month = "9",
doi = "10.1023/A:1025421416674",
language = "English (US)",
volume = "81",
pages = "41--51",
journal = "Breast Cancer Research and Treatment",
issn = "0167-6806",
publisher = "Springer New York",
number = "1",

}

TY - JOUR

T1 - A pilot study of dose intense doxorubicin and cyclophosphamide followed by infusional paclitaxel in high-risk primary breast cancer

AU - Zujewski, Jo Anne

AU - Eng-Wong, Jennifer

AU - O'Shaughnessy, Joyce

AU - Venzon, David

AU - Chow, Catherine

AU - Danforth, David

AU - Kohler, David R.

AU - Cusack, Georgia

AU - Riseberg, David

AU - Cowan, Kenneth H.

PY - 2003/9

Y1 - 2003/9

N2 - We conducted a pilot study of dose dense doxorubicin and cyclophosphamide (AC) combination chemotherapy followed by infusional paclitaxel (T) in primary breast cancer to determine its safety and feasibility. Twenty-two subjects (10 with stage II and ≥4 positive lymph nodes, and 12 with stage III disease) were treated with AC (A 60 mg/m2 and C 2000 mg/m2) with filgrastim every 14 days for three cycles followed by infusional paclitaxel (140 mg/m2 over 96 h) every 14 days for three cycles. Mean overall cycle length was 15.3 days and mean duration of therapy was 92 days. Dose reductions of C or T were required in 7/132 (5.3%) cycles for mucositis, diarrhea, or failure to recover platelets by day 15. Ninety-five percent of subjects had grade 4 neutropenia and 1 subject had a platelet nadir of <20,000. Actual delivered dose intensity (DI) over six cycles was: A 27 mg/m2 per week; C 892 mg/m2 per week; T 64 mg/m 2 per week (90.6, 89.2, and 91.4% of planned DI, respectively). Average total dose administered was: A 180 mg/m2; C 5880 mg/m 2; T 403 mg/m2 (100, 98, and 96% of planned total doses, respectively). Clinical response rate in 10 subjects receiving neoadjuvant therapy was 100% (4 complete response, 6 partial response). Four subjects had a pathologic complete response (three subjects without evidence of malignancy and one subject with ductal carcinoma in situ.) Administration of dose dense AC followed by infusional paclitaxel in 14-day cycles is feasible and this regimen is active in breast cancer.

AB - We conducted a pilot study of dose dense doxorubicin and cyclophosphamide (AC) combination chemotherapy followed by infusional paclitaxel (T) in primary breast cancer to determine its safety and feasibility. Twenty-two subjects (10 with stage II and ≥4 positive lymph nodes, and 12 with stage III disease) were treated with AC (A 60 mg/m2 and C 2000 mg/m2) with filgrastim every 14 days for three cycles followed by infusional paclitaxel (140 mg/m2 over 96 h) every 14 days for three cycles. Mean overall cycle length was 15.3 days and mean duration of therapy was 92 days. Dose reductions of C or T were required in 7/132 (5.3%) cycles for mucositis, diarrhea, or failure to recover platelets by day 15. Ninety-five percent of subjects had grade 4 neutropenia and 1 subject had a platelet nadir of <20,000. Actual delivered dose intensity (DI) over six cycles was: A 27 mg/m2 per week; C 892 mg/m2 per week; T 64 mg/m 2 per week (90.6, 89.2, and 91.4% of planned DI, respectively). Average total dose administered was: A 180 mg/m2; C 5880 mg/m 2; T 403 mg/m2 (100, 98, and 96% of planned total doses, respectively). Clinical response rate in 10 subjects receiving neoadjuvant therapy was 100% (4 complete response, 6 partial response). Four subjects had a pathologic complete response (three subjects without evidence of malignancy and one subject with ductal carcinoma in situ.) Administration of dose dense AC followed by infusional paclitaxel in 14-day cycles is feasible and this regimen is active in breast cancer.

KW - Breast cancer

KW - Dose dense chemotherapy

KW - Neoadjuvant chemotherapy

UR - http://www.scopus.com/inward/record.url?scp=10744231193&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=10744231193&partnerID=8YFLogxK

U2 - 10.1023/A:1025421416674

DO - 10.1023/A:1025421416674

M3 - Article

C2 - 14531496

VL - 81

SP - 41

EP - 51

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

IS - 1

ER -