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Cyclophosphamide/docetaxel Various toxicities: 9 case reports

Nine women with operable breast cancer received adjuvant IV infusions of cyclophosphamide 600 mg/m2 over 30min, followed by docetaxel 75 mg/m2 over 60min, scheduled every 3 weeks, with four courses planned. Dexamethasone was administered before and after each session. The patients had various toxicities, including skin rashes, stomatitis, dysphagia, anorexia, angioedema, respiratory disorders, joint and muscle pain, febrile neutropenia and wound infections [times to reaction onset not stated; see table]. Their chemotherapy was either suspended or delayed or their doses reduced. Patients also received symptomatic, supportive and alternate therapy [patient outcomes not stated].

Patient characteristics Chemotherapya Supportive treatment

Pt/ age (y)

Adverse events

1/44

rash, hives, angioedema

suspended after 2 courses

2/58

rash, hives, cough

suspended after 2 courses

3/60

stomatitis, dysphagia, anorexia

suspended after 3 courses

4/36

febrile neutropenia

dose reduced to 75% from 2nd course

Alternate therapy

H1 endocrine receptor therapy antagonist, ethanolamine H1 EC receptor therapyc antagonist, ethanolamine, topical steroid symptomatic Therapy treatment, suspended e.g., fluid replacement antibacterials -

docetaxel and cyclophosphamide; b granulocyte colony-stimulating factor; c not defined a

Patient characteristics (cont.) Pt/ age (y)

Adverse events

5/48

wound infection neutropenia, wound infection, weariness rash

6/55

7/61

8/59

febrile neutropenia

9/62

arthralgia, myalgia, upper respiratory inflammation

Chemotherapya Supportive treatment

Alternate therapy

2nd course delayed dose reduced to 75% from 3rd course

G-CSFb, antibacterials G-CSF, antibacterials

–

dose reduced to 75% from 3rd course dose reduced to 75% from 2nd course 4th course delayed

ethanolamine, topical steroid G-CSF, antibacterials

–

symptomatic treatment, e.g., analgesics

–

–

–

docetaxel and cyclophosphamide; b granulocyte colony-stimulating factor; c not defined a

Watanabe K, et al. Safety and tolerance of docetaxel (especially 75 mg/m2) with cyclophosphamide (TC therapy) as adjuvant chemotherapy for Japanese patients with operable breast cancer. Gan to Kagaku Ryoho 37: 1265-1269, No. 7, Jul 2010 803061863 [Japanese; summarised from a translation] - Japan

0114-9954/10/1375-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved

Reactions 29 Oct 2011 No. 1375