VILLEJUIF, France--Salvage therapy with docetaxel (Taxotere) produced
responses in more than a quarter of heavily pretreated, anthracycline-resistant
breast cancer patients, said Jean-Louis Misset, MD, an oncologist
at Paul Brousse Hospital, Villejuif.
The compassionate use program enrolled 241 patients at 19 French
centers. The patients had received a median of four previous chemotherapy
regimens. The group included 107 patients who had shown clinical
resistance to anthracy-clines, and 108 who had received the maximum
cumulative anthracycline dose.
"The patients all had poor prognoses, more than half with
liver involvement and 80% with multisite disease, but not all
had less than 3 months life expectancy," Dr. Misset said,
"Some had slowly growing disease. In these patients, we are
bound to find some alternative therapy. We can't just send them
Too Concerned With Toxicity?
Patients received docetaxel, 100 mg/m2 as a 1-hour infusion every
3 weeks, repeated six times if disease remained stable. The regimen
continued for nine or more courses in patients who responded or
had clinical improvement. Patients were premedicated with corticosteroids,
antihistamines, or both. Growth factor support was allowed, as
were diosmine and diuretics for fluid retention.
Of 217 patients evaluable for response, 40 (19%) have had partial
responses, and 18 (8%) have had minor responses. The median duration
of response has been 6 months. An additional 95 patients (44%)
have had disease stabilization.
Grade 4 neutropenia occurred in 87% of patients and 55% of cycles.
The three toxic deaths reported all involved febrile neutropenia
and sepsis. "I think Americans are too concerned with the
toxicity of Taxotere," Dr. Misset said in his report of the
results at the San Antonio Breast Cancer Symposium. "In our
experience, it can be handled."
He said that 101 patients remain in the program, indicating that,
in some patients, stabilization and responses have been maintained
for long durations.