In a phase II study, 27 patients with metastatic breast cancer were treated with oral etoposide as second-line chemotherapy at a dose of 50 mg/m2/day for 21 days, which courses were repeated every 4 weeks. Twenty-one patients were evaluable for response, and twenty-five for toxicity. In two (10%) patients a partial response was observed with a duration of 60 and 122 weeks respectively, and seven patients (33%) showed stable disease. Gastrointestinal toxicity was usually mild, though relatively frequent. Anemia grade II and III was observed in 20% of all courses (< 10% of all measurements), and leukopenia grade III and IV was observed in 22% of all courses (< 10% of all measurements). There was one toxic death. Reviewing the literature we calculated a response rate of intravenous etoposide treatment of 8% in 276 patients with metastatic breast cancer from 7 studies (response rates ranging between 0-14%), while (chronic) oral treatment caused a response rate of 19% in 145 patients from 8 different studies (response rates ranging between 0-35%).

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Breast Cancer Research and Treatment
Department of Medical Oncology

Bontenbal, M, Planting, A.S.Th, Verweij, J, de Wit, R, Kruit, W.H.J, Stoter, G, & Klijn, J.G.M. (1995). Second-line chemotherapy with long-term low-dose oral etoposide in patients with advanced breast cancer. Breast Cancer Research and Treatment, 34(2), 185–189. doi:10.1007/BF00665790