Low-dose oral methotrexate and cyclophosphamide in metastatic breast cancer: Antitumor activity and correlation with vascular endothelial growth factor levels

M. Colleoni, A. Rocca, M. T. Sandri, L. Zorzino, G. Masci, F. Nolè, G. Peruzzotti, C. Robertson, L. Orlando, S. Cinieri, F. De Braud, G. Viale, A. Goldhirsch

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Anticancer chemotherapy is thought to be effective by means of direct cytotoxicity on tumor cells. Alternative mechanisms of efficacy have been ascribed to several common anticancer agents, including cyclophosphamide (CTX), methotrexate (MTX), anthracyclines and taxanes, postulating an antiangiogenic activity. Patients and methods: We evaluated the clinical efficacy and impact on serum vascular endothelial growth factor (VEGF) levels of low-dose oral MTX and CTX in patients with metastatic breast cancer. MTX was administered 2.5 mg bd on days 1 and 2 each week and CTX 50 mg/day administered continuously. Results: Sixty-four patients were enrolled, 63 were evaluable: Eastern Cooperative Oncology Group (ECOG) performance status 0-1, ≥2 sites of metastatic disease (n = 50 patients), progressive disease at study entry (n = 51), 1 regimen for metastatic disease (n = 32) and ≥ 2 regimens (n = 20). Among the 63 evaluable patients, there were two complete remissions (CR), 10 partial remissions (PR) for an overall response rate of 19.0% (95% CI 10.2% to 30.9%) and an overall clinical benefit (CR+PR+ stable disease > 24 weeks) of 31.7% (95% CI 20.6% to 44.7%). Grade ≥2 leucopenia was registered in only 13 patients. The median serum VEGF level for the subgroup of patients on treatment for at least 2 months decreased with treatment from 315 pg/ml (95% CI 245 to 435) at baseline to 248 pg/ml (95% CI 205 to 311) at 2 months (P

Original languageEnglish
Pages (from-to)73-80
Number of pages8
JournalAnnals of Oncology
Volume13
Issue number1
DOIs
Publication statusPublished - 2002

Keywords

  • Angiogenesis
  • Breast cancer
  • Chemotherapy
  • Cyclophosphamide
  • Methotrexate

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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