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.
- 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
