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Tailored Chemotherapy to Equal Toxicity: Is It Possible?

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Adjuvant Therapy of Primary Breast Cancer VI

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 152))

Abstract

The intention of chemotherapy for a malignant disease can be either curative or palliative. In breast cancer the former applies to therapy of micrometastatic disease in the adjuvant setting or as a preoperative procedure, while conventionally delivered chemotherapy for metastatic disease is considered to be strictly palliative. The latter statement, however, is challenged by different dose-intensive concepts including the use of high-dose therapy supported by autologous bone marrow stem cells (Bezwoda et al. 1995). The prognosis for breast cancer has been improved by the use of early detection programmes and adjuvant therapy, while the prognosis for patients with metastatic breast cancer is still dismal (Early Breast Cancer Trialists’ Collaborative Group 1992; Nyström et al. 1993; Overgaard et al. 1997; Ragaz et al. 1997).

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References

  • Allerheiligen S, Johnson R, Hatcher B et al (1994) Gemcitabine pharmacokinetics are influenced by gender, body surface area (BSA) and duration of infusion. Proc Am Soc Clin Oncol 13:136

    Google Scholar 

  • Ardizzoni A, Venturini M, Sertoli M et al (1994) Granulocyte-macrophage colony-stimulating factor (GM-CSF) allows acceleration and dose intensity increase of CEF chemotherapy: a randomised study in patients with advanced breast cancer. Br J Cancer 69:385–391

    Article  PubMed  CAS  Google Scholar 

  • Bergh J (1997) Dose intensity in patients with metastatic breast cancer — time for novel thoughts? Ann Oncol 8:109–110

    Article  PubMed  CAS  Google Scholar 

  • Bergh J, Wiklund T, Erikstein B et al (1998) Dosage of adjuvant G-CSF (filgrastim) supported FEC polychemotherapy based on equivalent hematological toxicity to high risk breast cancer patients. Ann Oncol 9:403–411

    Article  PubMed  CAS  Google Scholar 

  • Bezwoda W, Seymour L, Dansey R (1995) High-dose chemotherapy with hematopoietic rescue as primary treatment for metastatic breast cancer: a randomized trial. J Clin Oncol 13:2483–2489

    PubMed  CAS  Google Scholar 

  • Bruno R, Hille D, Thomas L et al (1995) Population pharmacokinetics/pharmacodynamics (PK/PD) of docetaxel (Taxotere) in phase II studies. Proc Am Soc Clin Oncol 14:457

    Google Scholar 

  • Calvert A, Newell D, Gumbrell L et al (1989) Carboplatin dosage: prospective evaluation of a simple formula based on renal function. J Clin Oncol 7:1748–1756

    PubMed  CAS  Google Scholar 

  • Du Bois D, Du Bois E (1916) A formula to estimate the approximate surface area if height and weight be known. Arch Intern Med 17:863–871

    Google Scholar 

  • Early Breast Cancer Trialist Collaborative Group (1992) Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy. Lancet 339:1–15, 71-85

    Google Scholar 

  • EORTC New Drug Development Committee (1985) EORTC guidelines for phase I trials with single agents in adults. Eur J Cancer Clin Oncol 21:1005–1007

    Article  Google Scholar 

  • Evans W (1993) Alternative approaches for phase I studies of anticancer drugs: a role for therapeutic drug monitoring. Ther Drug Monit 15:492–497

    Article  PubMed  CAS  Google Scholar 

  • Evans W, Relling M (1989) Clinical pharmacokinetics-pharmacodynamics of anticancer drugs. Clin Pharmacokinet 16:327–336

    Article  PubMed  CAS  Google Scholar 

  • Grochow L, Baraldi C, Noe D et al (1990) Is dose normalization to weight or body surface area useful in adults? J Natl Cancer Inst 82:323–325

    Article  PubMed  CAS  Google Scholar 

  • Gurney H (1996) Dose calculation of anticancer drugs: a review of the current practice and introduction of an alternative. J Clin Oncol 14:2590–2611

    PubMed  CAS  Google Scholar 

  • Hutchison D, Schmid F (1973) Cross-resistance and collateral sensitivity. In: Mihich E (ed) Drug-resistance and selectivity: biochemical and cellular basis. Academic, New York, pp 73–126

    Google Scholar 

  • Lalisang R, Wils J, Nortier H et al (1997) Comparative study of dose escalation versus interval reduction to obtain dose-intensification of epirubicin and cyclophosphamide with granulocyte colony-stimulating factor in advanced breast cancer. J Clin Oncol 15:1367–1376

    PubMed  CAS  Google Scholar 

  • Lauterburg B, Preisig R (1991) Quantitation of liver function. In: McIntyre N, Bircher J et al (eds) Oxford textbook of clinical hepatology. Oxford University Press, Oxford, pp 309–314

    Google Scholar 

  • Mirza M, Jakobsen E, Pfeiffer P et al (1997) Suramin in non-small cell lung cancer and advanced breast cancer — two parallel phase II studies. Acta Oncol 36:171–174

    Article  PubMed  CAS  Google Scholar 

  • Muhonen T, Jantunen I, Pertovaara H et al (1996) Prophylactic filgrastim (G-CSF) during mutimycin-C, mitoxantrone, and methotrexate (MMM) treatment for metastatic breast cancer. Am J Clin Oncol 19:232–234

    Article  PubMed  CAS  Google Scholar 

  • Nyström L, Rutqvist L, Wall S et al (1993) Breast cancer screening with mammography: overview of Swedish randomised trials. Lancet 341:973–978

    Article  PubMed  Google Scholar 

  • Overgaard M, Hansen P, Overgaard J et al (1997) Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. N Engl J Med 337:949–955

    Article  PubMed  CAS  Google Scholar 

  • Paalzow L (1990) Therapeutical drug monitoring of anticancer drugs. In: Domellöf L (ed). Drug delivery in cancer treatment III. Springer, Berlin Heidelberg New York, pp 85–96

    Chapter  Google Scholar 

  • Pinkel D (1958) The use of body surface area as a criterion of drug dosage in cancer chemotherapy. Cancer Res 18:853–856

    PubMed  CAS  Google Scholar 

  • Ragaz J, Jackson S, Le N et al (1997) Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer. N Engl J Med 337:956–962

    Article  PubMed  CAS  Google Scholar 

  • Ratain M, Mick R, Schilsky R et al (1991) Pharmacologically based dosing of etoposide: a means of safely increasing dose intensity. J Clin Oncol 9:1480–1486

    PubMed  CAS  Google Scholar 

  • Saarto T, Blomqvist C, Rissanen P et al (1997) Haematological toxicity: a marker of adjuvant chemotherapy efficacy in stage II and III breast cancer. Br J Cancer 75:301–305

    Article  PubMed  CAS  Google Scholar 

  • Sandström M, Freijs A, Larsson R et al (1996) Lack of relationship between systemic exposure for the component drugs of the fluorouracil, epirubicin, and 4-hydroxycyclophos-phamide regimen in breast cancer patients. J Clin Oncol 14:1581–1588

    PubMed  Google Scholar 

  • Schabel FJ, Simpson-Herren L (1978) Some variables in experimental tumor systems which complicate interpretation of data from in vivo kinetic and pharmacologic studies with anticancer drugs. Antibiot Chemother 23:113–127

    PubMed  Google Scholar 

  • Smith I, Walsh G, Jones A et al (1995) High complete remission rates with primary neoadjuvant infusional chemotherapy for large early breast cancer. J Clin Oncol 13:424–429

    PubMed  CAS  Google Scholar 

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© 1998 Springer-Verlag Berlin · Heidelberg

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Bergh, J. (1998). Tailored Chemotherapy to Equal Toxicity: Is It Possible?. In: Senn, HJ., Gelber, R.D., Goldhirsch, A., ThĂĽrlimann, B. (eds) Adjuvant Therapy of Primary Breast Cancer VI. Recent Results in Cancer Research, vol 152. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-45769-2_32

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  • DOI: https://doi.org/10.1007/978-3-642-45769-2_32

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-45771-5

  • Online ISBN: 978-3-642-45769-2

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