Weekly paclitaxel improves response in metastatic breast cancer
Treatment with paclitaxel (Taxol) based on a weekly or two-weekly dosage regimen —rather than a three-weekly regimen — improves response and reduces toxicity, according to early studies in operable breast cancer reported at a conference last month.
One trial included 2,005 women with breast cancer that had spread to
the lymph nodes. They were randomised to doxorubicin and cyclophosphamide
followed by paclitaxel (175mg/m2) every three weeks or every two weeks.
The researchers found that more frequent treatment improved disease free
survival (risk ratio 0.74, P=0.010) and overall survival (0.69, P=0.013).
Christopher Poole, Cancer Research UK Trials Unit, University of Birmingham,
reported: “Four-year disease free survival was 82 per cent for
the dose-dense regimen — giving paclitaxel every two weeks — compared
with 75 per cent for the usual regimen.” Dr Poole noted that severe
neutropenia was less frequent in patients treated with dose-dense paclitaxel
(which was given with filgastrim to support blood cell count). He was
speaking at a meeting held in Rome to discuss the treatment of breast
cancer in Europe. The meeting was sponsored by an educational grant from
Bristol-Myers Squibb.
Helen Flint, clinical pharmacist, Christie Hospital NHS Trust, Manchester,
said: “We have seen encouraging results with weekly paclitaxel
in patients with metastatic breast cancer who could not have tolerated
other dosage regimens. More frequent dosing with a lower dose of paclitaxel
means that patients gain similar tumour response and relief from cancer
symptoms — particularly pain — as at higher doses, but with
fewer side effects.” |
The
Pharmaceutical Journal