title: Phase II study of docetaxel, doxorubicin, and cyclophosphamide as first-line chemotherapy for metastatic breast cancer.
abstract: OBJECTIVE
  This pilot phase II study investigated the efficacy and toxicity of docetaxel with doxorubicin and cyclophosphamide (TAC) as first-line chemotherapy for anthracycline-naive patients with metastatic breast cancer.
  
  
  METHODS
  Fifty-four patients received a total of 359 courses consisting of docetaxel 75 mg/m2 given intravenously (IV) over 1 hour, preceded by IV doxorubicin 50 mg/m2 and cyclophosphamide 500 mg/m2 for a maximum of eight 3-week cycles.
  
  
  RESULTS
  After an independent panel review, the overall objective response rate was 77% (complete response, 6%). Overall objective response rates in patients with visceral, bone, and liver involvement were 82%, 82%, and 80%, respectively. Median duration of response was 52 weeks, and median time to progression was 42 weeks. With a median follow-up of 32 months, the median survival had not yet been reached, whereas the 2-year survival was 57%. The main toxicities were hematologic (neutropenia grade 3/4 in 100% of patients and 95% of cycles; febrile neutropenia in 34% of patients and 9% of cycles). Documented grade 3 infection was seen in one patient (2%) in one cycle, and no toxic death was reported. Severe acute or chronic nonhematologic adverse events were infrequent, and docetaxel-specific toxicities (such as fluid retention and nail changes) were mild, with only one patient being discontinued for fluid retention. Congestive heart failure was seen in two patients (4%).
  
  
  CONCLUSIONS
  TAC is an active and manageable regimen that has been chosen as the basis of five randomized phase III trials, including two pivotal studies comparing TAC to fluorouracil plus doxorubicin and cyclophosphamide in the metastatic and adjuvant treatment of breast cancer.
authors.affiliation: Cross Cancer Institute, Edmonton, Alberta, Canada. jean-marc.nabholtz@bcirg.com
authors.forename: J M
authors.initials: JM
authors.lastname: Nabholtz
authors.forename: J R
authors.initials: JR
authors.lastname: Mackey
authors.forename: M
authors.initials: M
authors.lastname: Smylie
authors.forename: A
authors.initials: A
authors.lastname: Paterson
authors.forename: D R
authors.initials: DR
authors.lastname: Noël
authors.forename: T
authors.initials: T
authors.lastname: Al-Tweigeri
authors.forename: K
authors.initials: K
authors.lastname: Tonkin
authors.forename: S
authors.initials: S
authors.lastname: North
authors.forename: N
authors.initials: N
authors.lastname: Azli
authors.forename: A
authors.initials: A
authors.lastname: Riva
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage; D000077143:Docetaxel; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D017239:Paclitaxel / Q000008:administration & dosage / Q000031:analogs & derivatives*; D010865:Pilot Projects; D012074:Remission Induction; D016019:Survival Analysis; D043823:Taxoids
chemical_list: D043823:Taxoids; D000077143:Docetaxel; D004317:Doxorubicin; D003520:Cyclophosphamide; D017239:Paclitaxel