Treatment of advanced and refractory breast cancer with doxorubicin, vincristine and continuous infusion of verapamil. A phase I-II clinical trial.

F Ries, M Dicato
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引用次数: 20

Abstract

Cancer cell resistance to several cytotoxic drugs, including doxorubicin and vincristine can be reduced in vitro by verapamil; this drug works at least in part by inhibitive competition for the multiple-drug resistance efflux-pump P-glycoprotein-170. To evaluate the clinical potential of this experimental concept we combined verapamil in continuous infusion with adriamycin and vincristine in the treatment of patients with advanced and anthracycline-refractory breast cancer. Sixteen patients were included and 55 treatment courses were given at different dose levels of chemotherapy; verapamil was given by continuous infusion of 0.003 mg kg-1 min-1 for 48 h. Overall, cardiac toxicity was low but a potentiation of neurotoxicity and hematotoxicity was observed. The objective response rate was 21% (3 partial responses in 16 patients) and the median survival was 6 months; these results are comparable to those of other second line treatment studies, using drugs not supposed to be cross-resistant.

阿霉素、长春新碱联合维拉帕米持续输注治疗晚期难治性乳腺癌。I-II期临床试验。
维拉帕米可以在体外降低癌细胞对几种细胞毒性药物的耐药性,包括阿霉素和长春新碱;这种药物至少部分是通过抑制多药耐药外排泵p -糖蛋白170的竞争而起作用的。为了评估这一实验概念的临床潜力,我们联合维拉帕米持续输注阿霉素和长春新碱治疗晚期和蒽环类难治性乳腺癌患者。纳入16例患者,55个疗程给予不同剂量水平的化疗;维拉帕米连续输注0.003 mg kg-1 min-1 48 h。总体而言,心脏毒性较低,但观察到神经毒性和血液毒性增强。客观缓解率为21%(16例患者中3例部分缓解),中位生存期为6个月;这些结果与其他二线治疗研究的结果相当,这些研究使用的药物不应该是交叉耐药的。
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