Docetaxel Salvage Therapy Appears To Benefit Poor Prognosis Patients

VILLEJUIF, France--Salvage therapy with docetaxel (Taxotere) producedresponses in more than a quarter of heavily pretreated, anthracycline-resistantbreast cancer patients, said Jean-Louis Misset, MD, an oncologistat Paul Brousse Hospital, Villejuif.

The compassionate use program enrolled 241 patients at 19 Frenchcenters. The patients had received a median of four previous chemotherapyregimens. The group included 107 patients who had shown clinicalresistance to anthracy-clines, and 108 who had received the maximumcumulative anthracycline dose.

"The patients all had poor prognoses, more than half withliver involvement and 80% with multisite disease, but not allhad less than 3 months life expectancy," Dr. Misset said,"Some had slowly growing disease. In these patients, we arebound to find some alternative therapy. We can't just send themhome."

Too Concerned With Toxicity?

Patients received docetaxel, 100 mg/m2 as a 1-hour infusion every3 weeks, repeated six times if disease remained stable. The regimencontinued for nine or more courses in patients who responded orhad clinical improvement. Patients were premedicated with corticosteroids,antihistamines, or both. Growth factor support was allowed, aswere diosmine and diuretics for fluid retention.

Of 217 patients evaluable for response, 40 (19%) have had partialresponses, and 18 (8%) have had minor responses. The median durationof 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 neutropeniaand sepsis. "I think Americans are too concerned with thetoxicity of Taxotere," Dr. Misset said in his report of theresults at the San Antonio Breast Cancer Symposium. "In ourexperience, it can be handled."

He said that 101 patients remain in the program, indicating that,in some patients, stabilization and responses have been maintainedfor long durations.