Two studies published recently in the Journal of
Clinical Oncology showed promising response rates for docetaxel (Taxotere)-based
therapy over existing therapies for several types of cancer.
Early Use in Breast Cancer
The results of a study (J Clin Oncol 20:1456-1466, 2002) support the addition
of docetaxel to neoadjuvant chemotherapy for breast cancer. The study in women
with large (³ 3 cm) or locally advanced breast cancer showed that those who
received docetaxel following anthracycline-based chemotherapy achieved a better
tumor response rate than did those given the anthracycline-based regimen alone.
Treatment with an anthracycline-based regimen is currently the standard of care
in the neoadjuvant setting.
The study, conducted at the University of Aberdeen in the United Kingdom,
found that patients who responded to four cycles of neoadjuvant chemotherapy
with the anthracycline-based regimen CVAP (cyclophosphamide [Cytoxan, Neosar],
vincristine, doxorubicin [Adriamycin], prednisolone), followed by four cycles of
docetaxel, experienced a higher clinical response rate (94% vs 66%) and a higher
complete pathologic response rate (34% vs 16%) than patients given four
additional cycles of the anthracycline regimen.
"In localized breast cancer, the goal of chemotherapy given prior to
surgery is to reduce the size of the tumor, thus increasing the likelihood of
breast conservation and improving survival," said Steven Heys, professor of
surgical oncology and nutritional oncology, University of Aberdeen. "In
this study, patients given docetaxel in addition to an anthracycline-based
chemotherapy experienced a better response rate in terms of tumor reduction,
which suggests that patients given docetaxel are less likely to have to undergo
mastectomy following completion of the chemotherapy. These results strongly
support the addition of docetaxel to neoadjuvant chemotherapy in the treatment
of breast cancer."
Survival Benefit Demonstrated
Additional data from this study were presented at the 24th Annual San Antonio
Breast Cancer Symposium. According to data presented there, patients who
received the neoadjuvant docetaxel-containing regimen lived significantly longer
than patients who did not receive docetaxel. Patients in the CVAP/docetaxel arm
achieved a 97% 3-year survival rate, compared to 84% in patients in the CVAP/CVAP
arm. In addition, the disease-free survival rate at 3 years was 90% in the
docetaxel arm, compared with 77% in patients who did not receive docetaxel.