ORLANDOAdjuvant therapy for breast cancer can be improved
through the use of new agents, such as taxanes, Edith A. Perez,
MD, said at the Joint Cancer Conference of the Florida Universities.
Dr. Perez is associate professor of medicine, Mayo Medical School,
and director of the Clinical Investigation & Breast Cancer
Program, Mayo Clinic, Jacksonville, Florida.
With metastatic breast cancer, the data have been accumulated showing
that combinations such as epirubicin (Ellence) and a taxane achieve
high activity. We now feel that its reasonable to move
these combinations into clinical trials in the adjuvant setting,
Dr. Perez said in an interview with ONI.
Epirubicin became available in the United States this past fall,
based on a number of Canadian and European trials supporting its use.
We want to bring this innovative combination to the United
States and are now engaged in developing a study to support it,
Dr. Perez said.
Other studies in which she is involved are exploring the value of
various dosing regimens. One study is examining the use of paclitaxel
(Taxol) or docetaxel (Taxotere) at a regular weekly dosing regimen vs
3 weeks on and 1 week off. This may increase tolerability while
producing the same response rate, she said.
Another study has the goal of optimizing the schedule of chemotherapy
combined with the anti-HER-2/neu monoclonal antibody trastuzumab
(Herceptin). In this study, patients in one group will receive
chemotherapy every 3 weeks and Herceptin weekly. Patients in the
other group will undergo weekly chemotherapy and weekly Herceptin.
Yet another study that will begin soon will investigate whether
patients with a low degree of HER-2/neu expression can benefit from
Herceptin therapy. In that study, all the patients will receive
chemotherapy but half will get Herceptin and half will not. Herceptin
has already been shown to be effective in the treatment of patients
with a high degree of HER-2/neu expression, Dr. Perez said.