Paclitaxel and vinorelbine in anthracycline-pretreated breast cancer: A phase II study

Background: Paclitaxel and vinorelbine are active in advanced breast cancer pretreated with anthracyclines. We therefore conducted a phase II study to define the toxicity and activity of paclitaxel and vinorelbine administered in combination. Patients and methods: Our patient population consisted of 37 patients with metastatic breast cancer, 35 of whom had received prior chemotherapy including anthracyclines. The treatment regimen included vinorelbine (25 mg/m² i.v.) followed by paclitaxel (135 mg/m² i.v. as a 3-hour infusion) on day 1; vinorelbine was repeated on day 8 in the first 14 patients and on day 3 in the remaining 23 patients. Results: Because of grade 4 neutropenia, the second dose of vinorelbine was reduced or omitted in 88% of the courses on the days 1 and 8 schedule and in 48% of the courses on the days 1 and 3 schedule. As a consequence the administered dose intensity of vinorelbine was significantly higher on the days 1 and 3 schedule (13 mg/m²/wk versus 8.3 mg/m²/wk, P = 0.005). The overall response rate was 38% (95% CI: 22-55); four responses have been observed in the ten patients with absolute anthracycline resistance. The median duration of response was 6.5 months. Conclusions: The combination of paclitaxel and vinorelbine is a feasible and active salvage regimen in advanced breast cancer patients pretreated with anthracyclines.