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Dose-Dense Chemotherapy Regimen Shows Promise In Breast Cancer
A DGReview of :"Dose-dense biweekly doxorubicin/docetaxel versus sequential neoadjuvant chemotherapy with doxorubicin/cyclophosphamide/docetaxel in operable breast cancer: second interim analysis."
Clinical Breast Cancer
11/18/2002
By Alison Palkhivala
Use of a dose-dense biweekly schedule of doxorubicin and docetaxel is showing promise for the treatment of primary operable breast cancer, according to an interim analysis.
Jackisch C, Minckwitz and colleagues from the department of obstetrics and gynecology, University of Marburg, Germany, compared rates of complete pathologic remission among women with primary operable breast cancer treated with a dose-dense biweekly schedule of doxorubicin and docetaxel with those treated with a sequential administration of doxorubicin/cyclophosphamide followed by docetaxel.
For this randomized trial, women with primary operable breast cancer received a dose-dense biweekly schedule of four cycles of doxorubicin 50 mg/m2 and docetaxel 75 mg/m2 (ddAT) with or without tamoxifen or doxorubicin/cyclophosphamide followed by docetaxel (AC-DOC) over 24 weeks. For these interim results, data on 369 patients were available for the safety analysis and data on 378 were available for the efficacy analysis.
In terms of toxicity, both regimens were tolerable. Among patients taking ddAT, nearly 39.8 percent experienced grade 3 or 4 neutropenia, compared with 69.3 percent of those taking AD-DOC.
Overall, pathologic complete response occurred in 14.8 percent of the primary breast tumours. Enrollment in the study was interrupted early because of the significant difference in pathological complete response rates between the two groups. In total, 380 patients underwent surgery, and breast conservation was possible in 75.8 percent of patients.
According to the authors, these findings are encouraging, but they recommend caution until a statistical difference in efficacy between the two treatment arms with respect to pathologic complete response has been confirmed.
Clin Breast Cancer 2002 Oct;3(4):276-80.
"Dose-dense biweekly doxorubicin/docetaxel versus sequential neoadjuvant chemotherapy with doxorubicin/cyclophosphamide/docetaxel in operable breast cancer: second interim analysis."
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