Weekly
Paclitaxel Superior to Less Frequent Dosing in Metastatic
Breast Cancer
According to results presented at the 40th annual meeting
of the American Society of Clinical Oncology (ASCO), treatment
with paclitaxel (Taxol ®) every week provides superior
outcomes to treatment every 3 weeks with paclitaxel in women
with metastatic breast cancer.
Metastatic breast cancer refers to cancer that has spread
from the breast to distant and/or several sites in the body.
Standard treatment for metastatic breast cancer consists of
chemotherapy, either used as single agents or in combination
with other agents. Paclitaxel is a commonly used chemotherapy
agent in the treatment of metastatic breast cancer. Herceptin ®
(trastuzumab) is a monoclonal antibody that also may be used
in the treatment of metastatic breast cancer. Herceptin ®
was designed to target and bind to specific areas on a cancer
cell that overexpress the human epidermal growth factor receptor
(HER2), referred to as HER2-positive breast cancer. The binding
of Herceptin ® stimulates the immune system to help kill
the cancer cells and may have some direct killing effects
on the cancer cell. Researchers continue to evaluate different
scheduling and dosing of regimens to achieve optimal long-term
survival in these patients.
Researchers from Memorial-Sloan Kettering Cancer Center (MSKCC)
recently conducted a clinical trial to evaluate different
schedules of paclitaxel with or without Herceptin ® in
patients with metastatic breast cancer. Data from this trial
included approximately 700 patients, 580 of whom were directly
involved in this trial, and 120 of whom had participated in
the CALGB 9342 trial that utilized the same weekly paclitaxel
regimen. All patients had received prior therapy and were
treated with either paclitaxel every week or paclitaxel every
3 weeks. Patients who were HER2-positive were also treated
with Herceptin ®. Anti-cancer responses were achieved in
40% of patients treated with paclitaxel every week, compared
to only 28% of patients treated every 3 weeks. Time to cancer
progression was 9 months for patients treated with weekly
paclitaxel, compared to 5 months for those treated with paclitaxel
every 3 weeks. Overall survival was 24 months for patients
treated with weekly paclitaxel, compared to only 16 months
for those treated with paclitaxel every 3 weeks. Herceptin ®
did not improve outcomes in patients with HER2-negative breast
cancer. Weekly paclitaxel was associated with more numbness
and tingling of hands and feet, but with fewer abnormalities
of blood cell levels.
The researchers concluded that weekly paclitaxel with or
without Herceptin ® should become adopted as a new standard
dosing regimen for patients with metastatic breast cancer.
Patients with metastatic breast cancer who are to be treated
with paclitaxel may wish to speak with their physician regarding
their individual risks and benefits of weekly paclitaxel.
Reference: Seidman D, Berry C, Cirrincione C, et al. CALGB
9840: Phase III study of weekly (W) paclitaxel (P) via 1-hour
(h) infusion versus standard (s) 3h infusion every third week
in the treatment of metastatic breast cancer (MBC), with trastuzumab
(T) for HER2 positive MBC and randomized for T in HER2 normal
MBC. Proceedings from the 40th annual meeting of the American
Society of Clinical Oncology. New Orleans, LA. June 2004.
Abstract #512.
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