A preliminary analysis of combination therapy with vincristine, adriamycin, and prednimustine (VAP) in advanced...

Between March 1984 and May 1985, 29 patients with metastatic breast cancer and high-risk prognostic factors were treated with vincristine, 1.4 mg/m2 IV on day 1, Adriamycin, 40 mg/m2 IV on day 1, and prednimustine, 100 mg/m2 PO on days 3 to 7. Courses were repeated every 3 weeks. At the present time, 26 patients are evaluable for tumor response; 29 are evaluable for toxicity. Fourteen of 26 patients (53.8%) achieved a partial response lasting 2 to 9 months (median 5.5+). A complete response was not recorded. Ten of 26 patients (38.5%) had stable disease; two patients (7.7%) showed a primary tumor progression. Most common side effects were nausea, vomiting, and alopecia, all generally mild to moderate. Fourteen of 29 patients developed leukocytopenia, mainly of WHO grade 1; thrombocytopenia was registered in one patient only and a fall of hemoglobin in three patients only. In 15 patients, no hematologic toxicity occurred. These preliminary data suggest good antitumor activity and acceptable toxicity for vincristine-Adriamycin-prednimustine in patients with metastatic breast cancer.