Weekly paclitaxel raises breast cancer survival
Weekly administration of paclitaxel, following adjuvant therapy with doxorubicin and cyclophosphamide, improves survival in women with breast cancer, compared with a standard three-weekly regimen, new research shows.
A total of 4,950 women with axillary lymph node-positive or high-risk,
lymph node-negative breast cancer received four cycles of intravenous
doxorubicin and cyclophosphamide at three week intervals.
They were then randomised to receive intravenous paclitaxel or docetaxel
given at either three-week intervals for four cycles or one-week intervals
for 12 cycles (see Panel for dosing regimen).
The results showed that patients receiving weekly paclitaxel had an odds
ratio for
disease-free survival of 1.27 (P=0.006), compared with those receiving
paclitaxel every three weeks. Weekly paclitaxel was also associated with
improved overall survival (odds ratio 1.32; P=0.01).
The odds ratio for disease-free survival in patients given docetaxel
was 1.23 in those on three weekly therapy (P=0.02) and 1.09 in those
receiving weekly therapy (P=0.29).
The results were not found to differ whether the cancer was hormone receptor-positive
or negative, or positive or negative for HER2 (New England Journal
of Medicine 2008;
358:1663).
Dose regimen
All women received doxorubicin (60mg/m2)
and cyclophosphamide (600mg/m2) every three weeks for
four cycles.
Taxane therapy (by
intravenous
infusion) then consisted of: • Paclitaxel 175mg/m2 over three
hours every three weeks for four doses or
• Paclitaxel 80mg/m2 over one hour weekly
for 12 doses or
• Docetaxel 100mg/m2 over one hour every three
weeks for four doses or
• Docetaxel 35mg/m2 over one hour weekly for
12 doses |
|
The
Pharmaceutical Journal
Acrobat
Reader