Docetaxel increases breast cancer survival
Survival among women with operable, node-positive breast cancer is higher with adjuvant docetaxel therapy than with adjuvant fluorouracil therapy, according to new data.
In the breast cancer international research group trial, 1,491 women
with axillary node-positive breast cancer were randomised to receive
six cycles of treatment with either docetaxel plus doxorubicin and cyclophosphamide
(TAC) or fluorouracil plus doxorubicin and cyclophosphamide (FAC).
According to interim results, at median follow-up of 55 months, the estimated
rates of disease-free survival at five years were 75 per cent among patients
receiving TAC compared with 68 per cent among those receiving FAC. This
represents a 28 per cent reduction in the risk of relapse with TAC therapy
(P=0.001). Estimated rates of overall survival at five years were 87
per cent in the TAC group versus 81 per cent in the FAC group, and mortality
was reduced by 30 per cent with TAC therapy (P=0.008). Incidence of neutropenia
and infections were greater in the TAC group.
The researchers conclude that adjuvant chemotherapy with TAC has a therapeutic
advantage over FAC, but at the expense of increased toxic side effects
(New England Journal of Medicine 2005;352:2302).
Last month, a trial in which women with breast cancer were being treated
with docetaxel plus doxorubicin was terminated because the regimen was
associated with a high risk of life-threatening complications (PJ, 21
May, p605). |
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