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A phase II study of intensive-dose epirubicin/verapamil as induction therapy followed by intensive-dose ifosfamide for advanced breast cancer

  • High-Dose Ifosfamide, Epirubicin/Verapamil, Advanced Breast Cancer
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Summary

Preliminary data of an ongoing phase II-study in metastatic breast cancer patients are presented. Patients with metastatic breast cancer entered the study after hormone therapy had failed; prior treatment with cyclophosphamide, methotrexate and 5-fluorouracil (CMF) was also allowed. The patients were treated with three cycles of 40 mg/m2 epirubicin i. v. on days 1–3 and 4×120 mg oral verapamil on days 0–3, given every 3–4 weeks. After three chemotherapy courses, ifosfamide was given as a short infusion of 3 g/m2 on days 1–3. Mesna (20% of the total ifosfamide dose) was given 0, 4 and 8 h after ifosfamide administration. Response was evaluated after three cycles of epirubicin/verapamil and after the last (third) cycle of ifosfamide. The side effects of this treatment were tolerable. The epirubicin/verapamil combination was no more toxic than epirubicin alone. Despite the high dose of verapamil, systolic blood pressure remained above 80 mm Hg, and patients never had a period of strict bed rest. Alopecia was almost complete after induction therapy with epirubicin/verapamil, and nausea and vomiting were absent or mild during epirubicin/verapamil chemotherapy and were easily controlled by antiemetics during ifosfamide treatment. Stomatitis and mucositis, the main toxic effects, could be ameliorated by intensive mouth-washing procedures. The haematological toxicity was greater after epirubicin/verapamil treatment than after ifosfamide therapy, but neither bleeding nor infections due to thrombocytopenia or leucopenia were observed.

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Authors and Affiliations

  1. Department of Oncology-Hematology, Medical University Clinic, Martinistrasse 52, D-2000, Hamburg 20, Federal Republic of Germany

    T. Langenbuch, K. Mross & D. K. Hossfeld

  2. Gynecologic University Clinic, Martinistrasse 52, D-2000, Hamburg 20, Federal Republic of Germany

    W. Jonat

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  1. T. Langenbuch
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  2. K. Mross
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  3. W. Jonat
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  4. D. K. Hossfeld
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Langenbuch, T., Mross, K., Jonat, W. et al. A phase II study of intensive-dose epirubicin/verapamil as induction therapy followed by intensive-dose ifosfamide for advanced breast cancer. Cancer Chemother. Pharmacol. 26 (Suppl 1), S93–S96 (1990). https://doi.org/10.1007/BF00685433

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