Docetaxel in the treatment of advanced breast cancer

E Salminen, MD

Department of Radiotherapy and Oncology, Turku University, Turku, Finland

Introduction: This study investigates the efficacy and toxicity of docetaxel used as single agent and in combination with epirubicin in metastatic breast cancer. Patients and methods: Sixty-nine patients were included, 31 women, (median age 52 years, range 40-65) treated for metastatic breast cancer with docetaxel and 38 (median age, 51 years, range 35-72) with the combination of docetaxel and epirubicin. The treatment was given for 6 months in responding/ stable patients. When given as single agent, the starting dose was 100 mg/m2, reduced to 75 mg/m2 if liver function was reduced. In the combination regimen the starting dose of epirubicin was 75 mg/m2 and docetaxel 75mg/m2 every three weeks, reduced by 25 % if neutropenic infection occurred. Epirubicin was given as a 15-minute i.v. infusion, followed by a pause for 1 hour, where after docetaxel was administered as a 1-hour infusion. Results: The overall response (CR+PR) after single docetaxel was 48% (95%CI 29-66%). The duration of response was 7 months and the median survival after docetaxel was 11.5 months. The overall response rate after combined treatment was 54% (95% CI 37-71), with a median duration of response of 14.8 months. Median time to progression was 12 months, median survival 26 months. The scheduled dosing was reduced in majority of patients due to toxicity. Previous anthracyclines or schedule of the previous treatment with epirubicin did not have significant impact on docetaxel response rate, adverse effects or survival. Conclusion: We conclude that docetaxel is active in metastatic breast cancer even as third line treatment and with the individual dose adjustment, although the combination with epirubicin and use as first line treatment provides longer response duration and survival.

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Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Paris, France; February 9 - 12, 2002; in the section on Novel Therapies, Part 1.