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Neoadjuvant Docetaxel Improves Survival in Breast Cancer Patients: Presented at SABCS
By Charlene Laino
SAN ANTONIO, TX -- December 4, 2003 -- Primary chemotherapy with docetaxel significantly improves 5-year survival rates of women with breast cancer compared with standard neoadjuvant chemotherapy, according to results of the University of Aberdeen trial.
Andrew Hutcheon, MD, consultant medical oncologist, Grampian University Hospital Trust, Aberdeen, Scotland, United Kingdom, reported the findings here on December 3rd at the 26th Annual San Antonio Breast Cancer Symposium.
The study enrolled 162 women with T3, T4, or N2 breast cancers; who received four courses of cyclophosphamide, doxorubicin, vincristine and prednisolone for 5 days. The 102 patients who responded were then randomized to receive either four more courses of the same drugs or four courses of docetaxel. The patients who failed to respond all received four cycles of docetaxel.
At a median follow-up of 65 months, 5-year survival was 97% in the docetaxel arm and 78% in the anthracycline-based chemotherapy arm. This was significant at the P = .04 level, Dr. Hutcheon said.
In addition, disease-free survival rates were 90% and 72% in the docetaxel and anthracycline-based chemotherapy arms, respectively (P = .04).
The study also showed that patients who received neoadjuvant docetaxel had a higher complete pathological response rate -- 31% versus 15%, respectively (P = .06).
"This [better pathological response rate] resulted in significantly more breast conserving surgery in the docetaxel arm," Dr. Hutcheon said. "Breast-conserving therapy was possible in 67% of women who received docetaxel, compared with 49% of those who received anthracycline-based chemotherapy."
Docetaxel was better tolerated, with 48% of women developing neutropenia compared with 59% of those on conventional therapy, he said. Also, 60% and 69% of women, respectively, developed granulocytopenia. Both of these differences were statistically significant, Dr. Hutcheon said.
[Study title: Docetaxel Primary Chemotherapy in Breast Cancer: A Five Year Update of the Aberdeen Trial. Abstract 11]
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