Practical aspects in the treatment of metastatic breast cancer with administration of paclitaxel weekly

Purpose: The implementation of weekly treatment schedules combines an antitumor effect with reduced toxicity profiles compared to conventional three-weekly schedules. Thus, this treatment option would appear to be very appropriate for the treatment of metastastic breast cancer (MBC). Material and Methods: We report a retrospective analysis showing the outcome of 29 breast cancer patients (pts.) presenting with MBC (median age: 54 years, range 30 - 76). Overall, 25 pts. (86.2 %) were pretreated with anthracylines. The weekly paclitaxel schedule used ranged from 60-100 mg/m. A combination treatment with mitoxantrone (n = 6), epirubicine (n = 2) and trastuzumab (n = 6) was employed. Carcinosis of the bone marrow was treated with weekly doses of paclitaxel in one case only. Results: Objective remission was 51.7% including complete remission in 20.7%. Duration of the progression-free interval was 8.4 (0.5 - 36) months. A combination of paclitaxel administered weekly with trastuzumab turned out to offer the best remission. Treatment was well tolerated: leucopenic events occurred in 13.8%(grade III according WHO); neurotoxicity was grade II only. Conclusion: Treatment of MBC with weekly administration of paclitaxel alone or in combination either with other cytotoxic drugs or trastuzumab if appropriate is safe, effective and well tolerated. Toxicity profile is moderate. Our results in pretreated MBC patients confirm results from phase I-III trials. This schedule is of clinical use in all stages of MBC including infiltration of bone marrow.