At the 22nd Annual San Antonio Breast
Cancer Symposium, researchers reported that women with advanced
breast cancer may benefit more from chemotherapy with the drug
docetaxel (brand name, Taxotere) before breast surgery than from standard chemotherapy. In
a clinical trial with 163 women, researchers
discovered that women who were treated with docetaxel in addition to breast surgery and
drug treatment with tamoxifen had a significantly higher
treatment response rate compared with women who did not receive docetaxel.
The clinical trial included 163 women
with large or locally advanced breast cancers who had not received any prior treatment.
Each of the women in the trial received four cycles of standard chemotherapy
(cyclophosphamide, doxorubicin, vincristine, and prednisone). Patients who responded
positively to standard chemotherapy were then randomly assigned to receive either four
additional cycles of standard chemotherapy or four cycles of docetaxel (every three
weeks).
After four to six weeks of
chemotherapy, the women underwent breast surgery-either breast conserving therapy (lumpectomy and radiation
therapy) or mastectomy (removal of the affected
breast). Each patient was then treated with the drug tamoxifen
for five years after the surgery (unless she did not tolerate tamoxifen or there was no
evidence that the cancer had spread past the breast).
Of the 49 women who received docetaxel,
94% showed some response to treatment. Among the women who did not receive docetaxel (52
patients), only 67% showed a response to treatment. Among the remaining 49 women who did
not respond to standard chemotherapy and were treated with docetaxel alone, the overall
response rate was 47%.
The results of the trial reveal that
docetaxel should be considered for advanced breast cancer patients who receive
chemotherapy as part of their treatment, according to Professor Oleg Eremin of the
Grampian University Hospitals in Aberdeen, Scotland who led the trial. Though the results
of the trial need to be confirmed, docetaxel offers hope to women with advanced breast
cancer.
The most common side effects of
docetaxel reported during the trial included changes to finger or toe nails, diarrhea, and
indigestion. Neutropenia (a sharp decrease in white blood
cell count) and nausea were more common in patients who received standard chemotherapy
than patients whose treatment included docetaxel. Other possible side effects to docetaxel
include fluid retention, allergic reactions, and hair loss.
Docetaxel has also been shown to be
successful in advanced breast cancer patients prior to its approval by the U.S. Food and
Drug Administration (FDA) in 1998. In several clinical trials, high doses of docetaxel
were shown to reduce cancerous tumors in 42% of patients for an average of six months
while lower doses reduced tumors in 35% of patients for four months.
Docetaxel has a chemical structure
similar to the drug Taxol (generic name, paclitaxel) used
to treat early and advanced stages of breast cancer in women.
Like Taxol, docetaxel is typically administered intravenously (through a vein) in one-hour
sessions every twenty-one days. Some patients may need to be treated with medications to
prevent problems with fluid retention and allergic reactions before they receive the
docetaxel. Patients with liver problems may not be suited to receive docetaxel.
Additional Resources and
References
The December 10, 1999 Reuters Health
report, "New Chemo Drug Benefits Breast Cancer Patients," is available at http://www.reutershealth.com/eline/open/1999121015.html
The American Cancer Society provides
information on docetaxel at http://www3.cancer.org/cancerinfo/documents/cancer_5/docetaxel.asp?ct=5
For more information on chemotherapy,
please visit http://www.imaginis.com/breasthealth/chemo.asp
For more information on breast cancer
staging, please visit http://www.imaginis.com/breasthealth/staging.asp
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