Weekly Low Dose 4 Epi-Adriamycin-Effective Single Agent Chemotherapy for Advanced Breast Cancer with Low Toxicity

Abstract

This study is based on the experience of Mattsson et al (Clin. Therap. 2: 193–203, 1982) with low dose weekly adriamycin therapy. 4 epi-adriamycin is reported more effective (Casazza et al, 1978) and less toxic (Bonfante et al, 1979) than adriamycin. 39 patients with bi-dimensionally measurable lesions were given 4 epi-adriamycin 2pmg intravenously weekly. The majority (34/39) had received previous therapy to which they were resistant. All had advanced disease. Age range 42–89 (mean 64) performance status (WHO, 1978) range 0–3 (mean 2). The lesions were assessed by direct measurement or radiologically. The WHO criteria of response were used. 2 (5%) patients achieved Complete Response (duration: 52, 48 + weeks), 18 (46%) a Partial Response (duration: range 4–56, mean 30+ weeks). A No Change was seen in 11 (28%) patients (duration: 4–40+, mean 14+ weeks) and 8 (21%) showed Progression after (a minimum of) 4 weeks treatment. This gives an objective response rate of 51$, which is better than previously reported for any single agent. No significant toxicity was observed. No myelosuppression was seen. Nausea and vomiting (graded very slight and not occurring with every course) was seen in 3/39 (8%), occasional slight nausea in 8/39 (21%), and slight alopecia (similar to that with oral cyclophosphamide) in 8/39 (21%). All possible effects were recorded, the majority were negligible — 23 (59%) patients had no complaints. This therapy represents effective treatment without toxicity of clinical importance for patients with advanced breast cancer.