According to an article recently published in the Journal of the National Cancer Institute, the addition of the chemotherapy agent Taxotere® (docetaxel) following an anthracycline-containing chemotherapy regimen may improve disease-free survival among patients with early breast cancer.
Lymph-node positive breast cancer refers to breast cancer that has spread to the lymph nodes under the arm but not to distant sites in the body. Patients with lymph-node positive breast cancer are often treated with chemotherapy to reduce the risk of a cancer recurrence. Researchers continue to evaluate novel chemotherapy regimens that may provide the best survival with minimal side effects.
The anthracycline class of chemotherapy agents includes Adriamycin® (doxorubicin), Ellence® (epirubicin), Rheumetrex® (methotrexate), and Doxil® (liposomal encapsulated doxorubicin). Results from earlier trials have demonstrated that treatment with the chemotherapy agent Taxotere is more effective than treatment with anthracyclines. Researchers continue to evaluate optimal timing and sequencing of chemotherapy agents.
Researchers affiliated with the BIG 02-98 Collaborative Group recently conducted a clinical trial to compare chemotherapy regimens among women with lymph node-positive breast cancer. This trial included nearly 2,900 patients who were treated with one of four regimens:
- Sequential control: Adriamycin followed by CMF (cyclophosphamide, methotrexate and 5-fluorouracil)
- Concurrent control: Adriamycin plus cyclophosphamide followed by CMF
- Sequential docetaxel: Adriamycin followed by Taxotere followed by CMF
- Concurrent docetaxel: Taxotere plus Adriamycin followed by CMF
The results after five years of follow-up were as follows:
- Disease-free survival in the sequential and concurrent control groups was 73%.
- Disease-free survival was not significantly improved between the concurrent docetaxel group and the concurrent control group.
- Disease-free survival was 78% for patients in the sequential docetaxel group.
The researchers concluded that sequential administration of Taxotere following an anthracycline regimen improves disease-free survival at five years in early breast cancer. Patients with early breast cancer may wish to speak with their physician regarding their individual risks and benefits of all treatment options.
Reference: Francis P, Crown J, Di Leo A, et al. Adjuvant Chemotherapy With Sequential or Concurrent Anthracycline and Docetaxel: Breast International Group 02–98 Randomized Trial. Journal of the National Cancer Institute [early online publication]. January 8, 2008. DOI: 10.1093/jnci/djm287.