High-Dose 4′-Epiadriamycin for Treatment of Breast Cancer Refractory to Standard Dose Anthracycline Chemotherapy: Achievement of Second Responses

High-dose 4'-epiadriamycin chemotherapy (110-150 mg/m2) was administered to 18 patients (95 treatment cycles) with advanced breast cancer refractory to or showing progression after prior treatment with adriamycin containing combination chemotherapy regimens. Thirteen out of 18 patients showed an objective response to therapy including 1 with complete and 12 with partial response. Although haematologic suppression was profound (mean granulocyte nadir 0.3 +/- 0.1 x 10(6)/l) recovery was rapid and there was no evidence of cumulative haematologic toxicity. Cardiac toxicity was not encountered during therapy even after cumulative doses greater than 1,200 mg/m2 of anthracycline drugs. Although the response rate was high, response duration was short (median 5.8 months).