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Oral ftorafur plus intramuscular thiotepa as adjuvant chemotherapy in patients with breast cancer

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Abstract

In this study, we evaluated the safety and efficacy of a combination of oral ftorafur administered together with intramuscular thiotepa as adjuvant chemotherapy for “early” breast cancer patients. A total of 30 patients with operated breast cancer were treated with 500 mg/m2 oral ftorafur for 10 consecutive days plus 20 mg/m2 intramuscular (im) administered thiotepa on d 1 and 8 every 28 d adjuvant chemotherapy. Eleven patients were premenopausal and 19 were postmenopausal, with a median age of 53 yr. The total number of cycles delivered was 259 (median: 10 cycles per patient). Toxicity was low and usually consisted of leukopenia WHO grade I–II (14%) and neutropenia grade I–II (6%). Gastrointestinal toxicity was minimal. The 5-yr disease-free survival and overall survival were 55% and 84%, respectively. Relapse occurred as bone metastases (50%), local recurrence (25%), and liver (17%) and brain (8%) metastases. Our preliminary data showed that oral ftorafur and im thiotepa is a well-tolerated regimen and could be a useful alternative to the intravenous parenteral route as adjuvant treatment for early breast cancer. Randomized trials are needed to assess the possible advantage of this regimen over intravenous schedules.

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References

  1. Cufer, T. (1999). Adjuvant therapy of breast cancer: update. Ann. Oncol. 10:129–137.

    Article  PubMed  Google Scholar 

  2. Fisher, B., et al. (1997). Tamoxifen and chemotherapy for lymph node-negative, estrogen receptor-positive breast cancer. J. Natl. Cancer Inst. 89:1673–1682.

    Article  PubMed  CAS  Google Scholar 

  3. Early Breast Cancer Trialists’ Collaborative Group (1992). Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy. 133 randomised trials involving 31,000 recurrences and 24,000 deaths among 75,000 women. Early Breast Cancer Trialists’ Collaborative Group. Lancet 339:1–15.

    Google Scholar 

  4. Early Breast Cancer Trialists’ Collaborative Group (1998). Polychemotherapy for early breast cancer: an overview of the randomised trials. Early Breast Cancer Trialists’ Collaborative Group. Lancet 352:930–942.

    Article  Google Scholar 

  5. Goldhirsch, A., Glick, J.H., Gelber, R.D. and Senn, H.J. (1998). Meeting highlights: International Consensus Panel on the Treatment of Primary Breast Cancer. J. Natl. Cancer Inst. 90:1601–1608.

    Article  PubMed  CAS  Google Scholar 

  6. Hortobagyi, G.N. and Buzdar, A.U. (1995). Current status of adjuvant systemic therapy for primary breast cancer: progress and controversy. CA Cancer J. Clin. 45:199–226.

    Article  PubMed  CAS  Google Scholar 

  7. Bonadonna, G., et al. (1976). Combination chemotherapy as an adjuvant treatment in operable breast cancer. N. Engl. J. Med. 294:405–410.

    Article  PubMed  CAS  Google Scholar 

  8. Misset, J.L., et al. (1996). Adjuvant treatment of node-positive breast cancer with cyclophosphamide, doxorubicin, fluorouracil, and vincristine versus cyclophosphamide, methotrexate, and fluorouracil: final report after a 16-year median follow-up duration. J. Clin. Oncol. 14:1136–1145.

    PubMed  CAS  Google Scholar 

  9. Hortobagyi, G.N., Buzdar, A.U., Marcus, C.E. and Smith, T.L. (1986). Immediate and long-term toxicity of adjuvant chemotherapy regimens containing doxorubicin in trials at M.D. Anderson Hospital and Tumor Institute. NCI Monogr. 1:105–109.

    PubMed  Google Scholar 

  10. Ellis, G. and Livingston, R.B. (1993). Feasibility of dose-intensive continuous 5-fluorouracil, doxorubicin, and cyclophosphamide as adjuvant therapy for breast cancer. Cancer 71:392–396.

    Article  PubMed  CAS  Google Scholar 

  11. Catimel, G., et al. (1994). FAC (fluorouracil, doxorubicin, cyclophosphamide) as second line chemotherapy in patients with metastatic breast cancer progressing under FEC (fluorouracil, epirubicin, cyclophosphamide) chemotherapy. Ann. Oncol. 5:95–97.

    PubMed  CAS  Google Scholar 

  12. Bennett, J.M., et al. (1988). A randomized multicenter trial comparing mitoxantrone, cyclophosphamide, and fluorouracil with doxorubicin, cyclophosphamide, and fluorouracil in the therapy of metastatic breast carcinoma. J. Clin. Oncol. 6:1611–1620.

    PubMed  CAS  Google Scholar 

  13. Vogel, C.L., et al. (1984). Randomized trial of cyclophosphamide, doxorubicin, and 5-fluorouracil alone or alternating with a cycle active non-cross-resistant combination in women with visceral metastatic breast cancer: a Southeastern Cancer Study Group project. J. Clin. Oncol. 2:643–651.

    PubMed  CAS  Google Scholar 

  14. Fetting, J.H., et al. (1998). Sixteen-week multidrug regimen versus cyclophosphamide, doxorubicin, and fluorouracil as adjuvant therapy for node-positive, receptor-negative breast cancer: an Intergroup study. J. Clin. Oncol. 16:2382–2391.

    PubMed  CAS  Google Scholar 

  15. Allegra, C. and Grem, J. (1997). Pharmacology of cancer chemotherapy — antimetabolites, in Cancer—Principles and Practice of Oncology. (De Vita, V.T., Hellman, S. and Rosenberg, S.A. eds), pp432–435. JB Lippincott, Philadelphia.

    Google Scholar 

  16. Fisher, B., Slack, N., Katrych, D. and Wolmark, N. (1975). Ten year follow-up results of patients with carcinoma of the breast in a co-operative clinical trial evaluating surgical adjuvant chemotherapy. Surg. Gynecol. Obstet. 140:528–534.

    PubMed  CAS  Google Scholar 

  17. Perloff, M., et al. (1996). Postsurgical adjuvant chemotherapy of stage II breast carcinoma with or without crossover to a non-cross-resistant regimen: a Cancer and Leukemia Group B study. J. Clin. Oncol. 14:1589–1598.

    PubMed  CAS  Google Scholar 

  18. Miller, A.B., Hoogstraten, B., Staquet, M. and Winkler, A. (1981). Reporting results of cancer treatment. Cancer 47:207–214.

    Article  PubMed  CAS  Google Scholar 

  19. Sobin, L.H. and Wittekind, C.H. (1997). UICC TNM Classification of Malignant Tumours, Wiley, New York.

    Google Scholar 

  20. Au, J.L. and Sadee, W. (1980). Activation of Ftorafue [R,S-1-(tetrahydro-2-furanyl)-5-fluorouracil] to 5-fluorouracil and gamma-butyrolactone. Cancer Res. 40:2814–2819.

    PubMed  CAS  Google Scholar 

  21. Brade, W.P. and Herdrich, K. (1983). Tegafur. A review of pharmacology and toxicology. Contr. Oncol. 14:2–25.

    CAS  Google Scholar 

  22. Pazdur, R. (1997). Phase I and pharmacokinetic evaluations of UFT plus oral leucovorin. Oncology 11:35–39.

    PubMed  CAS  Google Scholar 

  23. Hirata, K., Sasaki, K., Yamamitsu, S. and Shirasaka, T. (1993). A comparison of 5-fluorouracil concentration of 5-fluorouracil drip infusion versus orally UFT in plasma of same patients. Gan To Kagaku Ryoho 20:1409–1411.

    PubMed  CAS  Google Scholar 

  24. Ansfield, F.J., Kallas, G.J. and Singson, J.P. (1983). Phase I–II studies of oral tegafur (ftorafur). J. Clin. Oncol. 1:107–110.

    PubMed  CAS  Google Scholar 

  25. Palmeri, S., et al. (1990). Oral tegafur in the treatment of gastrointestinal tract cancers: a phase II study. Br. J. Cancer 61:475–478.

    PubMed  CAS  Google Scholar 

  26. Taguchi, T. (1997). Clinical application of biochemical modulation in cancer chemotherapy: biochemical modulation for 5-FU. Oncology 54:12–18.

    Article  PubMed  CAS  Google Scholar 

  27. Petrelli, N., et al. (1989). The modulation of fluorouracil with leucovorin in metastatic colorectal carcinoma: a prospective randomized phase III trial. Gastrointestinal Tumor Study Group. J. Clin. Oncol. 7:1419–1426.

    PubMed  CAS  Google Scholar 

  28. Leichman, C.G., et al. (1995). Phase II study of fluorouracil and its modulation in advanced colorectal cancer: a Southwest Oncology Group study. J. Clin. Oncol. 13:1303–1311.

    PubMed  CAS  Google Scholar 

  29. Nogue, M., et al. (1998). Protracted treatment with tegafur and low dose oral leucovorin in patients with advanced colorectal carcinoma. Cancer 83:254–258.

    Article  PubMed  CAS  Google Scholar 

  30. Tamura, H., et al. (2000). Randomized comparative study of CMF (cyclophosphamide, methotrexate and 5-fluorouracil) and UFT-tamoxifen regimens as adjuvant chemotherapy after surgery for breast cancer: Tochigi Prefectural Study Group for Post-Breast Cancer Adjuvant Chemotherapy. Gan To Kagaku Ryoho 27:993–1002.

    PubMed  CAS  Google Scholar 

  31. Imoto, S. (1997). Feasibility of adjuvant chemotherapy for breast cancer patients. Jpn. J. Clin. Oncol. 27:310–315.

    Article  PubMed  CAS  Google Scholar 

  32. Abe, O. (1994). The role of chemoendocrine agents in postoperative adjuvant therapy for breast cancer: meta-analysis of the First Collaborative Studies of Postoperative Adjuvant Chemoendocrine Therapy for Breast Cancer (ACETBC). Breast Cancer P:-P9.

  33. Semiglazov, V.F., et al. (1986). Clinical trials on adjuvant chemotherapy for breast cancer. Cancer 57:1957–1960.

    Article  PubMed  CAS  Google Scholar 

  34. Yoshida, M., et al. (1993). A comparative study among ftorafur, ftorafur plus tamoxifen, and tamoxifen in adjuvant therapy for breast cancer. The Chubu Cooperative Study Group of Adjuvant Chemoendocrine Therapy for Breast Cancer, Japan. Gan To Kagaku Ryoho 20:2325–2333.

    PubMed  CAS  Google Scholar 

  35. Hill, M., et al. (1995). Impact of protracted venous infusion fluorouracil with or without interferon alfa-2b on tumor response, survival, and quality of life in advanced colorectal cancer. J. Clin. Oncol. 13:2317–2323.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division Medicina, Hospital Municipal de Oncologia “María Curie”, Buenos Aires, Argentina

    C. M. Galmarini, C. Garbovesky, D. Galmarini & F. C. Galmarini

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  1. C. M. Galmarini
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  2. C. Garbovesky
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  3. D. Galmarini
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  4. F. C. Galmarini
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Correspondence to C. M. Galmarini.

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Galmarini, C.M., Garbovesky, C., Galmarini, D. et al. Oral ftorafur plus intramuscular thiotepa as adjuvant chemotherapy in patients with breast cancer. Med Oncol 19, 227–232 (2002). https://doi.org/10.1385/MO:19:4:227

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  • DOI: https://doi.org/10.1385/MO:19:4:227

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