Docetaxel-cisplatin combination (DC) chemotherapy in patients with anthracycline-resistant advanced breast cancer

Purpose: The safety and efficacy of a docetaxel-cisplatin combination (DC) were evaluated in 41 patients pretreated for advanced breast cancer (ABC). Patients and methods: The first 2 patients received 85 mg/m² docetaxel followed, 6 hours later, by 80 mg/m² cisplatin repeated every 3 weeks; the other 39 received the same regimen, with 75 mg/m² docetaxel. Appropriate dose reductions but no growth factor administration were planned. Treatment was continued until disease progression, excessive toxicity or patient refusal. Results: A total of 223 chemotherapy courses were administered, with a median of 6 cycles per patient (range 1-8). All 41 patients were assessed for toxicity using NCI-CTC. Severe neutropenia was experienced by 38 patients (93%) (11 at grade 3, 27 at grade 4, 10 with febrile neutropenia). There was one death due to neutropenic septic shock. Grade 3 thrombocytopenia occurred in three patients (7%). Five patients (12%) had grade 2 neurosensory toxicity, two (5%) experiencing partial hearing loss. Grade 3 fluid retention occurred in three patients (7%). Of 38 anthracycline-resistant patients, 33 were evaluable for response. Two had a complete response (CR) and ten a partial response (PR), giving an objective response rate of 36%, (95% CI: 20%-55%). Stable disease (SD) was observed in 14 patients (42%), 7 (21%) had progressive disease (PD). Among the three non- resistant patients, two PRs and one SD were observed. Median duration of response was 29 weeks (range 18-70), median time to progression 21 weeks (4- 70), and median overall survival 50 weeks (4-104+). Conclusions: This DC regimen is active, with an acceptable safety profile in anthracycline- resistant ABC patients. Its place as a second-line treatment alternative to docetaxel alone or to other second-line combination regimens remains to be determined.