Docetaxel given after doxorubicin reduces recurrence

Adding the drug docetaxel to anthracycline-based chemotherapy slightly improved disease-free survival in breast cancer patients, according to a randomized clinical trial published online January 8 in the Journal of the National Cancer Institute.

Docetaxel has previously been shown to be more effective than doxorubicin (an anthracycline) for treating patients with advanced breast cancer. Therefore, researchers wanted to test it in patients receiving chemotherapy after surgery.

Prudence Francis, M.D., of the Peter MacCallum Cancer Centre in Melbourne, Australia, and colleagues conducted a randomized, controlled phase III trial that compared patients who received doxorubicin-based chemotherapy with and without docetaxel. The trial also examined whether docetaxel should be given after doxorubicin or at the same time. The researchers compared disease-free survival for each treatment.

Overall, patients receiving the docetaxel treatment had an improvement in disease-free survival that was borderline statistically significant. Patients receiving docetaxel after doxorubicin had a five-year disease-free survival rate of 78 percent, compared with 74 percent for those receiving the two drugs at the same time. Patients in the control arm—those who received only doxorubicin-based chemotherapy—had a five-year disease-free survival rate of 73 percent. However, there was no statistically significant difference in overall survival between patients who received docetaxel and those who did not.

“Important differences may be related to doxorubicin and docetaxel scheduling, with sequential, but not concurrent, administration appearing to produce better [disease-free survival] than anthracycline-based adjuvant chemotherapy,” the authors write.