Weekly Taxol best for followup breast cancer care
BOSTON (Reuters Life!) - Women whose breast cancer may have spread survive a bit longer with weekly infusions of the drug Taxol than less-frequent treatments or treatment with a similar drug, researchers reported on Wednesday.
The chance of surviving and being free of breast cancer after five years was 27 percent higher among women who received 12 weekly treatments with Taxol, known generically as paclitaxel, compared to standard care with the drug being given every three weeks for 12 weeks.
"This represents a new option for women whose cancer has spread to the lymph nodes," Dr. Joseph Sparano of the Montefiore-Einstein Cancer Center in New York, said in a statement.
Usually Taxol, sold by Bristol-Myers Squibb, is given at a high dose every three weeks following surgery and treatment with other chemotherapy drugs.
In the Sparano study, 5,000 women who received the generic chemotherapy drugs doxorubicin and cyclophosphamide got one of four followup treatments.
Of the 1,200 women who got Taxol every three weeks, the estimated five-year survival rate was 86.5 percent, compared to 89.7 percent for the 1,200 who once a week received a dose that was a little less than half the amount of the other group's.
For the women who got docetaxel, which is also known by Sanofi-Aventis brand name Taxotere, survival rates were 87.3 percent for those who got treatments every three weeks and 86.2 percent when a smaller dose was given once a week.
The side-effects were also a bit less for women given smaller, weekly infusions.
The findings run counter to reports that Taxol might not help women with the most common form of breast cancer, estrogen-receptor-positive disease.
"The results of this study provide reassuring evidence that paclitaxel is effective for most women with breast cancer, although it appears that it must be given weekly in order for it to be effective," Sparano said.
What breastcancer.org says about this article…
Weekly Taxol best for followup breast cancer care
The study reviewed here found that getting Taxol (chemical name: paclitaxel) weekly had more benefits than getting Taxol every 3 weeks for women diagnosed with breast cancer that had spread to the lymph nodes or women diagnosed with breast cancer that hadn't spread to the lymph nodes but was considered high risk. Getting Taxol every week also had more benefits than getting Taxotere (chemical name: docetaxel) weekly or every 3 weeks for these women.
In this study of 5,000 women, more women who received Taxol once a week were likely to be alive and free of breast cancer 5 years after being diagnosed compared to women who received Taxol every 3 weeks OR women who received Taxotere (either weekly or every 3 weeks). All the women received Adriamycin (chemical name: doxorubicin) and Cytoxan (chemical name: cyclophosphamide) before receiving either Taxol or Taxotere.
For women diagnosed with early-stage, lymph-node-positive breast cancer, treatment often includes chemotherapy with Adriamycin and Cytoxan followed by a taxane. This chemotherapy regimen is sometimes called AC followed by T. Taxol, Taxotere, and Abraxane (chemical name: paclitaxel) are all taxanes. In the AC followed by T regimen, a taxane is usually given as 4 treatments over 12 weeks -- 1 treatment every 3 weeks.
In this study, the researchers compared the usual schedule of giving Taxol or Taxotere every 3 weeks to a different schedule that gave a lower dose of Taxol or Taxotere every week for 12 weeks. The women who got Taxol every week were 27% more likely to be alive and free of breast cancer 5 years after diagnosis compared to those who received the standard Taxol treatment schedule. The women who got Taxol every week also were more likely to be alive 5 years after diagnosis compared to women who got Taxotere (either weekly or every 3 weeks). Abraxane was not looked at in this study.
For each medicine and treatment schedule the chances of being alive 5 years after diagnosis are:
- Taxol once a week: 89.7%
- Taxol once every 3 weeks: 86.5%
- Taxotere once every 3 weeks: 87.3%
- Taxotere once a week: 86.2%
Some doctors have wondered whether a taxane has benefits for women diagnosed with hormone-receptor-positive breast cancer. This study found that women diagnosed with hormone-receptor-positive breast cancer did benefit from getting a taxane.
Women who got Taxol or Taxotere once a week instead of every 3 weeks seemed to have less severe side effects from the chemotherapy. This is probably because each Taxol or Taxotere dose was slightly less than half the standard dose. On the other hand, these women had to get treatment every week instead of every 3 weeks. It may be harder to plan your life around getting treatment every week than getting treatment every 3 weeks.
If chemotherapy that includes a taxane is going to be a part of your treatment plan, you might want to talk to your doctor about this study and consider asking these questions:- Which taxane (Taxol, Taxotere, or Abraxane) is recommended for me? Why?
- Which treatment schedule (weekly or every 3 weeks) is recommended? Why?
In the breastcancer.org Chemotherapy section you can learn more about how chemo works, when it's used, and the combinations that might be used.