Taxotere / Cyclophosphamide Improves Disease-Free Survival

Reviewed study: "Taxotere / Cyclophosphamide Improves Disease-Free Survival" by S. E. Jones and others, San Antonio Breast Cancer Symposium, December 11, 2005, Abstract 40

Is this for me? You might want to read this article if you have early-stage breast cancer and are considering chemotherapy.

Background and importance of the study: Taxotere (chemical name: docetaxel) was approved by the U.S. Food and Drug Administration for use by women with node-positive breast cancer after initial surgery. This approval, in August 2004, was based on new studies for women with this type of cancer, plus a long track record of earlier studies for women with advanced disease.

Research has shown that adding Taxotere to the FEC chemotherapy regimen (5-fluorouracil, epirubicin, and cyclophosphamide) reduces the risk of recurrence (the cancer coming back) and improves overall survival in women with node-positive breast cancer.

The study reported here looked at whether the combination of Taxotere and cyclophosphamide offered more benefits than the combination of Adriamycin (chemical name: doxorubicin) and cyclophosphamide for women with early-stage breast cancer, with positive OR negative lymph nodes.

Adriamycin/cyclophosphamide has been the standard chemotherapy regimen for women with early-stage breast cancer for many years. But Adriamycin is known to cause heart problems, while Taxotere does not. Finding an effective treatment plan that avoids this side effect would be an important treatment advance. And since new medicines that many women will take with or after chemotherapy, such as Herceptin (chemical name: trastuzumab), can also affect heart function, there's even more reason to find heart-safe therapies.

Study design: In this study, 1,016 women with early-stage breast cancer all had surgery to remove the cancer. Then all the women received chemotherapy:

• Half received four cycles of Taxotere and cyclophosphamide.
• Half received four cycles of Adriamycin and cyclophosphamide.

After chemotherapy, the women had radiation therapy. Women with hormone-receptor-positive breast cancer were given tamoxifen after radiation.

After about five years, the researchers compared the two groups of women to see:

• how long the women lived without the cancer coming back (called "disease-free survival"), and
• how many women were alive (called "overall survival").

Results: Looking at disease-free survival, the researchers found that:

• 86% of the women who received Taxotere and cyclophosphamide had no cancer come back.
• 81% of the women who received Adriamycin and cyclophosphamide had no cancer come back.

This difference was significant, meaning that it was likely due to the Taxotere and not just to chance.

Looking at overall survival, the researchers found that:

• 89% of the women who received Taxotere and cyclophosphamide were alive.
• 88% of the women who received Adriamycin and cyclophosphamide were alive.

This difference was not significant.

Neither group had any heart problems associated with treatment.

Conclusions: The Taxotere/cyclophosphamide (TC) chemotherapy regimen provided longer disease-free survival than the Adriamycin/cyclophosphamide (AC) regimen in these women with early-stage breast cancer. The researchers concluded that the TC regimen may provide greater benefits than AC chemotherapy for women with early-stage breast cancer. Although the effects of AC and TC on the heart were similar in this study, earlier studies indicate that TC is probably safer for the heart than AC.

• Research News on Chemotherapy (40 Articles)