Summary
Forty-two women with measurable or evaluable advanced breast cancer who had received neither prior chemotherapy for advanced disease nor any anthracycline-containing regimen as adjuvant were entered in a phase II study of mitoxantrone (Novantrone®; dihydroxyanthracenedione). Patients were aged from 36 to 80 years, performance status was from 0 to 2. All patients had normal hematological status and normal renal and liver function tests. Cardiac scintigraphy and sonography techniques were used to monitor cardiac function. Mitoxantrone was administered at a dose of 14 mg/m2 in 100 ml 5% dextrose solution over 30 minutes, repeated every three weeks.
The number of courses per patient ranged from 2 to 12. Of 42 eligible patients 39 were fully evaluable for response and all for drug toxicity. Responses to treatment were: complete response four patients, partial response 10 patients, stable disease 18 patients and progressive disease seven patients. The overall response rate was 36% (95% confidence limits 20–52%). Three patients showed decreased left ventricular ejection fraction but no patient developed signs of overt left ventricular failure during the treatment period. Hematological and gastrointestinal toxicities were mild. Hair loss was minimal.
The data indicate that mitoxantrone is an effective agent for the treatment of advanced breast cancer with mild side-effects, especially with respect to nausea/vomiting, hair loss and cardiotoxicity.
Similar content being viewed by others
References
Carter SK: Integration of chemotherapy into combined modality treatment of solid tumours. VII. Adenocarcinoma of the breast. Cancer Treat Rev 3:141–174, 1976
Tranum B, Hoogstraten B, Kennedy A, Vaughn CB, Samal B, Thigpen T, Rivkin S, Smith F, Palmer RL, Costanzi J, Tucker WG, Wilson H, Maloney TR: Adriamycin in combination for the treatment of breast cancer. Cancer 41:2078–2083, 1978
Smith IE: Mitoxantrone (Novantrone): A review of experimental and early clinical studies. Cancer Treat Rev 10:103–115, 1983
Neidhart JA, Gochnour D, Roach RW, Steinberg JA, Young D: Mitoxantrone versus doxorubicin in advanced breast cancer: A randomized cross-over trial. Cancer Treat Rev 10 (Suppl B): 41–46, 1983
Prentice HG, Robbins G, Ma DDF, Ho AD: Sequential studies on the role of mitoxantrone in the treatment of acute leukemia. Cancer Treat Rev 10 (Suppl B):57–63, 1983
Coltman CA Jr, McDaniel TM, Balcerzak SP, Morrison FS, Von Hoff DD: Mitoxantrone hydrochloride in lymphoma. Cancer Treat Rev 10 (Suppl B):73–76, 1983
Manual of Cancer Chemotherapy. UICC Techn. Rep. vol. 56, Geneva, 1981, pp 17–26
WHO Handbook for Reporting Results of Cancer Treatment. WHO Offset Publication No. 48, Geneva, 1979
Alexander J, Dainiak N, Berger HJ, Goldman L, Johnstone D, Reduto L, Duffy T, Schwartz P, Gottschalk A, Zaret BL: Serial assessment of doxorubicin cardiotoxicity with quantitative radionuclide angiocardiography. N Eng J Med 300:278–283, 1979
Kaplan EL, Meier P: Non-parametric estimation from incomplete observations. J Am Stat Assoc 53:457–481, 1958
Henderson CI, Canellos GP: Cancer of the breast. The past decade. N Eng J Med 302:17–30 & 78–90, 1980
Carbone PP, Bauer M, Band P, Tormey D: Chemotherapy of disseminated breast cancer — Current status and prospects. Cancer 39:2916–2922, 1977
Mouridsen HT, Palshof T, Brahm M, Rahbek I: Evaluation of single-drug versus multiple-drug chemotherapy in the treatment of advanced breast cancer. Cancer Treat Rep 61:47–50, 1977
Davis TE, Carbone PP: Drug treatment of breast cancer. Drugs 16:441–464, 1978
Yap HY, Esparza L, Blumenschein GN, Hortobagyi GN, Bodey GP: Combination chemotherapy with cyclophosphamide, mitoxantrone and 5-fluorouracil in patients with metastatic breast cancer. Cancer Treat Rev 10 (Suppl B): 53–55, 1983
Stewart D, Maroun J, Hirte W, Perrault D, Stolbach L, Cripps C, Lefebvre B: A randomised comparison of mitoxantrone vs Adriamycin combined with cyclophosphamide and 5-fluorouracil as front line chemotherapy of advanced breast cancer. ASCO Abstracts C-464, 1984
Von Hoff DD, Pollard E, Kuhn J, Murray E, Coltman CA Jr: Investigation of 1, 4-dihydroxy-5, 8-bis ((2- ((2-hydroxyethyl) amino) ethyl) amino)-9, 10-anthracenedione dihydrochloride (NCS 301739), a new anthracenedione. Cancer Res 40:1516–1518, 1980
Hagenberg L, Loynds P, Nagel GA: Mitoxantrone HCl, 1, 4-dihydroxy-5, 8-bis ((2- ((2-hydroxyethyl) amino) ethyl) amino)-9, 10-anthracenedione dihydrochloride (NCS 301739), Ein Neues Zylostaticum. Onkologie 6:322–328, 1980
Mouridsen HT, Rose G, Nooy MA, van Oosterom AT: Mitoxantrone as first line cytotoxic therapy in advanced breast cancer: preliminary results of a phase II study. Cancer Treat Rev 10 (Suppl B):47–52, 1983
Crossley RJ: Clinical safety and tolerance of mitoxantrone (Novantrone). Cancer Treat Rev 10 (Suppl B):29–36, 1983
Stuart-Harris RC, Bozek T, Pavlidis NA, Smith IE: Mitoxantrone: An active new agent in the treatment of advanced breast cancer. Cancer Chemother Pharmacol 12:1–4, 1984
Benjamin RS, Chawla SP, Ewer MS, Carrasco CH, MacKay B, Haynie III TP, Yap HY, Blumenschein GR, Holmes F, Ali MK, Bodey GP: Evaluation of mitoxantrone cardiac toxicity by nuclear angiography and endomyocardial biopsy. ASCO Abstracts C-156, 1984
Dorr RT, Jones SE: Toxicity of doxorubicin. In SE Jones (ed.) Current Concepts in the Use of Doxorubicin Chemotherapy, Farmitalia Carlo Erba, Milano, 1982, pp 147–154
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Landys, K., Borgstrom, S., Andersson, T. et al. Mitoxantrone as a first-line treatment of advanced breast cancer. Invest New Drugs 3, 133–137 (1985). https://doi.org/10.1007/BF00174160
Issue Date:
DOI: https://doi.org/10.1007/BF00174160