Docetaxel (Taxotere): an effective agent in the management of second-line breast cancer.
Despite improvements in detection and management, metastatic breast cancer remains a leading cause of death among women in industrialized countries. Chemotherapy is the initial treatment of choice for patients with a negative estrogen receptor status, as well as for those with a positive estrogen receptor status who have failed to respond to endocrine treatment. Patients who fail on first-line chemotherapy become candidates for second-line salvage chemotherapy; the outlook for these patients is poor, and new active agents continue to be sought. Docetaxel (Taxotere; Rhône-Poulenc Rorer, Antony, France) is a semisynthetic taxoid that is an inhibitor of microtubule depolymerization. This new anticancer agent has been studied in an extensive phase II clinical trial program involving 162 patients with second-line metastatic breast cancer, 134 of whom were anthracycline resistant. Doses of 100 mg/m2 of docetaxel, administered over 1 hour every 3 weeks, produced an overall response rate of 50% (range, 41% to 58%) in 129 evaluable patients, with a median duration of 6 months (range, 2 to 17 months). The response rates achieved to date with docetaxel in anthracycline-resistant patients compare favorably with those produced by the best monotherapies currently available, and are equivalent to those achieved with current combination chemotherapy options. Docetaxel also was found to be highly effective in patients with a poor prognosis, having metastases in three or more organs (53%), and/or visceral sites of disease (47%). Furthermore, the overall response rate for docetaxel in the intent-to-treat population (42.5%) is superior to the response rate of either doxorubicin as second-line therapy (29.3%) or paclitaxel (Taxol; Bristol-Myers Squibb Oncology, Princeton, NJ) when used as first- or second-line therapy (29%) in metastatic disease. In conclusion, docetaxel appears to be a very effective therapeutic option for women with second-line metastatic breast cancer.
van Oosterom
A T
AT
The Department of Oncology, Antwerp University Hospital, Edegem, Belgium.
D000970:Antineoplastic Agents / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D017322:Clinical Trials, Phase II as Topic; D000077143:Docetaxel; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016019:Survival Analysis; D043823:Taxoids; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D043823:Taxoids; D000077143:Docetaxel; D017239:Paclitaxel