A phase II study of docetaxel and vinorelbine plus filgrastim for HER-2 negative, stage IV breast cancer: SWOG S0102

Julie R. Gralow, William E. Barlow, Danika Lew, Kim Dammann, George Somlo, Kristine J. Rinn, Stanley J. Vogel, Lucas Wong, Robert B. Livingston, Gabriel N. Hortobagyi

Research output: Contribution to journalArticle

Abstract

Docetaxel and vinorelbine have demonstrated Single-agent activity in breast cancer. Preclinical studies suggest potential synergy between these antitubulin chemotherapy agents. This study evaluates these drugs in combination in metastatic breast cancer. Taxane-naive patients with HER-2 negative, stage IV breast cancer without prior chemotherapy for metastatic disease, were eligible. Docetaxel (60 mg/m2) was given intravenously on Day 1, vinorelbine (27.5 mg/m2) intravenously on Days 8 and 15, and filgrastim on Days 2-21 of a 21-day cycle. The primary study outcome was one-year overall survival (OS), with secondary outcomes of progression-free survival (PFS), response rate (RR), and toxicity. Of 95 patients registered, 92 were eligible and received treatment. One-year OS was 74 % (95 % CI 64-82 %) with a median OS of 22.3 months (95 % CI 18.8-31.4 months). One-year PFS was 34 % (95 % CI 24-43 %) with median of 7.2 months (95 % CI 6.4-10.3). OS at 2 and 3 years were 49 % (95 % CI 38-59 %) and 30 % (95 % CI 21-40 %), respectively. OS was poorer for women with estrogen-receptor negative disease (n = 32) compared to estrogen-receptor positive (n = 60) (log-rank p = 0.031), but PFS was not significantly different (p = 0.11). RR was 59 % among the 74 patients with measurable disease. Grade 3 and 4 adverse events were 48 and 16 %, respectively. Grade 4 neutropenia was 12 % and grade 3/4 febrile neutropenia was 3 %. Common grade 3/4 nonhematologic toxicities were fatigue (14 %), pneumonitis (10 %), and dyspnea (9 %). The combination of docetaxel and vinorelbine is an active first-line chemotherapy in HER-2 nonoverexpressing, metastatic breast cancer. This combination is associated with significant hematologic and nonhematologic toxicity. The safety profile and expense of the filgrastim limit recommendations for routine use.

Original languageEnglish (US)
Pages (from-to)351-358
Number of pages8
JournalBreast Cancer Research and Treatment
Volume143
Issue number2
DOIs
StatePublished - Jan 1 2014

Keywords

  • Breast cancer
  • Docetaxel
  • Metastatic
  • Vinorelbine

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Gralow, J. R., Barlow, W. E., Lew, D., Dammann, K., Somlo, G., Rinn, K. J., Vogel, S. J., Wong, L., Livingston, R. B., & Hortobagyi, G. N. (2014). A phase II study of docetaxel and vinorelbine plus filgrastim for HER-2 negative, stage IV breast cancer: SWOG S0102. Breast Cancer Research and Treatment, 143(2), 351-358. https://doi.org/10.1007/s10549-013-2797-2