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Which new cytotoxic drugs demonstrate sufficient efficacy and acceptable toxicity for the treatment of advanced breast cancer?
Which new cytotoxic drugs demonstrate sufficient efficacy and acceptable toxicity for the treatment of advanced breast cancer?
Among newly evaluated cytotoxic drugs for advanced breast cancer, epirubicin, idarubicin, and mitoxantrone show sufficient activity to justify clinical use, with mitoxantrone offering a less toxic alternative to doxorubicin and epirubicin.
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May inform selection among anthracyclines in advanced breast cancer; leaves open randomized trials to confirm positioning.
Over the past 5-10 years approximately 40 new drugs have been evaluated for their efficacy in patients with advanced breast cancer, usually heavily pretreated. Among 9 anthracyclines and anthracycline analogs, epirubicin, idarubicin and mitoxantrone have demonstrated activity which justifies their introduction into clinical practice. Efficacies of epirubicin and doxorubicin are similar and slightly superior to that of mitoxantrone, whereas mitoxantrone is less toxic. Randomized comparisons of doxorubicin or epirubicin versus idarubicin have yet to be conducted. Among 36 non-anthracycline analogs tested only vindesine and cisplatinum have been associated with activities which deserve further studies.
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Henning T. Mouridsen (1990) studied this question.
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