
<b>High Dose Epirubicin with Granulocyte Colony Stimulating Factor Support</b>

This is included because some preliminary results indicate that high dose Epiadriamycin [epirubicin] with the hematological support of GCSF's might be a powerful chemotherapy agent.  The high dose regimen of epirubicin is more toxic than the usual dose, and will require the hematological support.  Preliminary results are below.

<b>Search Pubmed for &&url
Search Pubmed for &&url


Increasing single epirubicin doses in advanced soft tissue sarcomas.</b>
J Clin Oncol 2002 Mar 1;20(5):1329-34
Lopez M, Vici P, Di Lauro L, Carpano S. 
Division of Medical Oncology B, Regina Elena Institute for Cancer Research, Rome, Italy.  

"...Sixty-one patients were treated at three different epirubicin dose levels: 140 mg/m(2) (six patients), 160 mg/m(2) (52 patients), and 180 mg/m(2) (three patients). Cycles were repeated every 3 weeks for a maximum of eight cycles. The first two dose levels proved to be feasible and safe without dose-limiting toxicity (DLT). Because the first three patients entering the third dose level experienced DLT, subsequent patients received the next lower dose level."

"The overall response rate was 44% ... with six complete (10%) and 21 partial (34%) responses. Responses seemed related to epirubicin dose level, because the response rate was 17%, 44%, and 100% for the three dose levels ... Median response duration, median time to progression, and median overall survival were 10, 8, and 15 months, respectively."

"Myelosuppression was the most frequent side effect, with grade 3 or 4 neutropenia occurring in 79% of the patients; 31% of patients were febrile. "

"The third epirubicin dose level  (180 mg/m(2)) was the maximum-tolerated dose. The recommended drug dose for clinical use is 160 mg/m(2) every 3 weeks with hematopoietic support. Single high-dose epirubicin is effective as first-line treatment and
should be preferentially used whenever a high response rate is important to allow the resection of an otherwise unresectable disease or whenever it might result in a significant symptomatic benefit."
&&url PMID: 11870176 