| Adjuvant and Neoadjuvant Chemotherapy for Breast Cancer San Antonio Breast Cancer Symposium 2005 Lee Schwartzberg, MD, FACP |
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| Date: December 8-11, 2005 |
| Location: San Antonio, Texas |
| Author: Lee Schwartzberg, MD, FACP |
Full text here: http://professional.cancerconsultants.com/conference_sabcs_2005.aspx?id=35828
"Adjuvant Chemotherapy - Refining the Role of Taxanes
Several large adjuvant trials evaluating the worth of taxanes were presented this year. The most eagerly awaited was ECOG-1199, testing two different hypotheses in a 2 x 2 design: First, whether there was a clinical advantage to Taxotere vs. Taxol and, secondly, whether weekly or every-three-week scheduling of taxanes was superior.[7] Five thousand women were randomized to one of four arms, 88% had lymph node positive disease and 20% were HER-2 positive. Taxol given every three weeks was considered the standard arm and was compared to Taxol weekly or Taxotere given weekly or every three weeks as the experimental arms. At a median follow up of 47 months at this fourth interim analysis there is no significant difference between Taxol and Taxotere (p = 0.83) nor between dose schedules weekly vs. every three weeks. However, an explanatory analysis revealed that weekly Taxol vs. every-three-week Taxol was 20% better, p = 0.06. The Taxotere arms did not differ significantly from Taxol every three weeks but had more Grade III and IV hematologic toxicity. So far the findings of E-1199 provide no reason to alter our current approaches to adjuvant chemotherapy of breast cancer.
A German adjuvant study compared 6 cycles of FEC to 4 cycles of FEC plus eight weeks of Taxol in node positive patients.[8] At 46 months of median follow up, FEC plus Taxol had a DFS of 85% vs. 79% for FEC alone for an HR of 0.063 (p = 0.006). Overall survival is numerically better for FEC plus taxol, 94% vs. 92% for FEC, which is not yet statistically significant. Toxicity was manageable in both arms."
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