Invited Speaker

Tolerability of Anthracyclines in Turkish Breast Cancer Patients
N. Serdar Turhal
Turkey

Introduction: The dose of anthracyclines in the adjuvant treatment of the breast cancer is relatively standardized in the western world. In Turkey, we attempt to treat the patients with a similar dose and schedule outlined in these studies. Through the years, during interpersonal communication in between medical oncologists, we observe that the toleration of the Turkish patients to anthracyclines is poorer than what has been reported in the western literature. We are concerned that this poor toleration causes dose reductions and as a result, the Turkish patients receive lower than ideal cumulative doses of anthracyclines.

Material & Methods: We studied the cumulative anthracycline doses in breast cancer patients treated in Marmara University Hospital. Only patients treated with epirubucin 90-100 mg/m2 in combination with cyclophosphamide and 5Fluoruracil are included for homogeneity of data. The degree and the type of toxicity causing the dose reduction are also noted.

Results: A total of 110 patients treated in Marmara University Hospital between 2006 and 2009 have been studied. The median age of the patients was 50 (31-82). The median follow up was 24 months. The relative dose intensity rate was 0.876 (042-1.06) and it was not significantly lower than what has been reported in the western literature. The T or N stage, age, occupation, comorbidity had no association with dose intensity. The only parameter that made a difference was the schema of the treatment being CE or CEF. The dose limiting grade 3-4 toxicity was asthenia and gastrointestinal problems.

Conclusion: Although our personal impression and initial goal was different, our data prove that the toleration of the Turkish breast cancer patients to epirubucin is not any different than what is reported in western studies. Still, we believe the dosing of chemotherapeutic agents should not be universal. Before introducing a new drug to a regional market, few pivotal exploratory studies should be done to find out the ideal dosing for patients in that particular region.