The combination of two chemotherapy medicines, Adriamycin (chemical name: doxorubicin) and Cytoxan (chemical name: cyclophosphamide), often referred to as AC, is commonly used after surgery to treat any breast cancer cells that may remain the body and to lower the risk that the cancer will come back.
The study reviewed here found that women who got a combination of Taxotere (chemical name: docetaxel) and Cytoxan, referred to as TC, had a 31% better chance of survival than women who got the AC combination. In addition to either chemotherapy combination, many women in the study also received radiation therapy and hormonal therapy (if the cancer was hormone-receptor-positive).
These results reinforce the results of earlier research. Taxotere belongs to a group of medicines called taxanes. Other taxanes include Taxol (chemical name: paclitaxel) and Abraxane (chemical name: albumin-bound paclitaxel). Adriamycin belongs to a group of medicines called anthracyclines.
These results were presented at the 2007 San Antonio Breast Cancer Symposium. While not mentioned in this article, other results presented at the meeting showed that only 8% of all newly diagnosed breast cancers will respond to Adriamycin or other anthracyclines. These cancers that respond to anthracyclines are HER2-positive and also have an abnormal Topo IIa gene. The research suggests that the other 92% of breast cancers should be treated with different types of chemotherapy medicines.
Adriamycin and other anthracyclines are common chemotherapy medicines for breast cancer. But anthracyclines can have some troubling side effects, including the risk of potentially permanent heart damage. Anthracyclines also can increase the risk of leukemia. Avoiding these risks by choosing a different type of chemotherapy combination such as TC makes sense. Especially if that chemotherapy combination works better.
Still, all chemotherapy medicines cause side effects. Taxotere can cause a number of side effects including nausea, vomiting, hair loss, and pain and tingling in the hands and feet (neuropathy). These side effects usually go away after treatment is done.
Based on this and other research studies, TC may replace AC as a standard chemo combination to treat breast cancer. If you're deciding on a chemotherapy treatment plan with your doctor, you might want to ask whether the TC combination would be a good option for you. Your doctor will consider factors such as:
when recommending a specific treatment plan. Together, you and your doctor will develop a treatment plan that's best for YOU.
NEW YORK (Reuters Health) - The long-term findings of a large, multicenter study show that breast cancer survival is significantly improved and side effects are significantly less severe with Taxotere (also called docetaxel) than with Adriamycin (also called doxorubicin).
The findings "have the potential to be practice-changing," principal investigator Dr. Stephen Jones of the US Oncology Medical Center in Houston, Texas told Reuters Health.
Jones presented his group's findings today, the opening day of the San Antonio Breast Cancer Symposium.
The trial involved 1,016 women with breast cancer who had complete surgical excision of the primary tumor. In approximately half of the women, the cancer had not spread to the lymph nodes.
Between June 1997 and December 1999, women were randomly assigned to four cycles of Taxotere plus cyclophosphamide or four cycles of standard therapy with Adriamycin plus cyclophosphamide, administered by infusion every 3 weeks as adjuvant or "add-on" chemotherapy.
Radiation therapy and tamoxifen were given after completion of chemotherapy for patients with so-called hormone receptor-positive disease.
There was a significant survival advantage with Taxotere, Jones announced. "Stated another way, these women had a 31 percent lower risk of dying during follow-up" than those receiving the gold standard, he said.
Taxotere has the "added advantage of fewer and less severe adverse effects," Jones said. Adriamycin has a significant risk of cardiac toxicity, especially in older women. It is also associated with some types of leukemia, he explained.
Taxotere does have some side effects, however. It can still cause nausea and vomiting and hair loss, "but this is not as severe as with (Adriamycin)," the Houston investigator said. "We have shown that a lot of women with early breast cancers don't have to receive Adriamycin-based regimens."
Taxotere plus cyclophosphamide "would appear to be the new standard of care for node-negative women and for those with involvement of up to three local nodes...We don't have a lot of information on women with more than four positive nodes," Jones acknowledged.
"Now that we can see this survival advantage, we can incorporate this regimen into other treatment regimens with other agents," Jones added.
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