Recently initiated studies: neoadjuvant treatments in the next century.
The adjuvant therapy of early breast cancer currently succeeds in eradicating micrometastatic disease in a proportion of women at risk of relapse. However, much remains to be done to improve its efficacy. Trials that are presently being conducted will determine whether increasing the dose density or dose intensity of existing agents, or altering their sequencing, will bring greater benefit. A further pressing need is for new agents with proven activity in stage IV disease, such as docetaxel (Taxotere; Rhône-Poulenc Rorer, Antony, France), to be assessed in the adjuvant setting. A phase II study with docetaxel was conducted in the neoadjuvant setting in stage III breast cancer patients. Preliminary results on 33 patients showed an overall response rate of 85% with neoadjuvant docetaxel and a manageable safety profile. Based on this encouraging experience and the phase II and III docetaxel single-agent and combination studies, the National Surgical Adjuvant Breast Project is investigating regimens involving docetaxel before or after surgery, and ongoing European trials are assessing the sequencing of dose-dense doxorubicin and docetaxel before surgery.
Gradishar
W J
WJ
Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60611-2926, USA.
D000970:Antineoplastic Agents / Q000494:pharmacology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D002470:Cell Survival / Q000187:drug effects; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D000077143:Docetaxel; D005260:Female; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage / Q000031:analogs & derivatives; D043823:Taxoids
D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel; D017239:Paclitaxel