[Mitoxantrone in a combination regimen in advanced breast cancer]

The new anthracendione mitoxantrone, an anthraquinone derivate with structural similarities to doxorubicin (adriamycin) is active in the treatment of patients with metastatic breast cancer. It has less acute toxicity than doxorubicin, may be non cross resistant with doxorubicin and appears to have less cardiotoxicity. Phase-II-studies have confirmed antitumor activity ranging from 6 to 36%, mitoxantrone combined with conventional drugs produced response rates between 25 and 90%. 32 heavily pretreated patients--nearly 70% had visceral metastasis--were assigned to treatment with vindesine 3 mg/m2 i.v. and mitoxantrone 10 to 12 mg/m2 by i.v. infusion. Treatment cycles initially were repeated every 3 weeks. 25/32 patients are available for response. There were 1 complete remission (4%), 3 partial remissions (12%), 2 minor responses (8%) (remissions + minor responses = 24%), 7 no change (28%) and 12 failures (48%). Response durations were 11, 8, +5, +6 months. The acute toxicity was mild, nausea or vomiting grade greater than or equal to 2 were found only in 4/32 patients (12%), the rate of alopecia grade greater than or equal to 2 was 28% (only 2 patients [6%] required a wig). Myelosuppression on the other hand was moderate. Nearly two thirds of patients developed leucopenia less than 2,0 X 10(9)/I, in 22% of patients platelet nadir less than 100,0 X 10(9)/I was registered. In conclusion these preliminary results suggest an improvement in therapeutic index with this treatment regimen.