PURPOSE: This phase III study compared docetaxel and doxorubicin in patients with metastatic breast cancer who had received previous alkylating agent-containing chemotherapy. PATIENTS AND METHODS: Patients were randomized to receive an intravenous infusion of docetaxel 100 mg/m(2) or doxorubicin 75 mg/m(2) every 3 weeks for a maximum of seven treatment cycles. RESULTS: A total of 326 patients were randomized, 165 to receivedoxorubicin and 161 to receive docetaxel. Overall, docetaxel produced a significantly higher rate of objective response than did doxorubicin (47.8% v 33.3%; P =.008). Docetaxel was also significantly more active than doxorubicin in patients with negative prognostic factors, such as visceral metastases (objective response, 46% v 29%) and resistance to prior chemotherapy (47% v 25%). Median time to progression was longer in the docetaxel group (26 weeks v 21 weeks; difference not significant). Median overall survival was similar in the two groups (docetaxel, 15 months; doxorubicin, 14 months). There was one death due to infection in each group, and an additional four deaths due to cardiotoxicity in the doxorubicin group. Although neutropenia was similar in both groups, febrile neutropenia and severe infection occurred more frequently in the doxorubicin group. For severe nonhematologic toxicity, the incidences of cardiac toxicity, nausea, vomiting, and stomatitis were higher among patients receiving doxorubicin, whereas diarrhea, neuropathy, fluid retention, and skin and nail changes were higher among patients receiving docetaxel. CONCLUSION: The observed differences in activity and toxicity profiles provide a basis for therapy choice and confirms the rationale for combination studies in early breast cancer.
RCT Entities:
PURPOSE: This phase III study compared docetaxel and doxorubicin in patients with metastatic breast cancer who had received previous alkylating agent-containing chemotherapy. PATIENTS AND METHODS: Patients were randomized to receive an intravenous infusion of docetaxel 100 mg/m(2) or doxorubicin 75 mg/m(2) every 3 weeks for a maximum of seven treatment cycles. RESULTS: A total of 326 patients were randomized, 165 to receive doxorubicin and 161 to receive docetaxel. Overall, docetaxel produced a significantly higher rate of objective response than did doxorubicin (47.8% v 33.3%; P =.008). Docetaxel was also significantly more active than doxorubicin in patients with negative prognostic factors, such as visceral metastases (objective response, 46% v 29%) and resistance to prior chemotherapy (47% v 25%). Median time to progression was longer in the docetaxel group (26 weeks v 21 weeks; difference not significant). Median overall survival was similar in the two groups (docetaxel, 15 months; doxorubicin, 14 months). There was one death due to infection in each group, and an additional four deaths due to cardiotoxicity in the doxorubicin group. Although neutropenia was similar in both groups, febrile neutropenia and severe infection occurred more frequently in the doxorubicin group. For severe nonhematologic toxicity, the incidences of cardiac toxicity, nausea, vomiting, and stomatitis were higher among patients receiving doxorubicin, whereas diarrhea, neuropathy, fluid retention, and skin and nail changes were higher among patients receiving docetaxel. CONCLUSION: The observed differences in activity and toxicity profiles provide a basis for therapy choice and confirms the rationale for combination studies in early breast cancer.
Authors: Xinrong Guo; Sibylle Loibl; Michael Untch; Volker Möbus; Kathrin Schwedler; Peter A Fasching; Jana Barinoff; Frank Holms; Christoph Thomssen; Dirk M Zahm; Rolf Kreienberg; Maik Hauschild; Holger Eidtmann; Sascha Tauchert; Keyur Mehta; Gunter von Minckwitz Journal: Breast Care (Basel) Date: 2011-08-19 Impact factor: 2.860
Authors: Andrew C Gordon; William J Gradishar; Virginia G Kaklamani; Avesh J Thuluvath; Robert K Ryu; Kent T Sato; Vanessa L Gates; Riad Salem; Robert J Lewandowski Journal: J Vasc Interv Radiol Date: 2014-08-22 Impact factor: 3.464
Authors: Stacy Moulder; Gregory Gladish; Joe Ensor; Ana Maria Gonzalez-Angulo; Massimo Cristofanilli; James L Murray; Daniel Booser; Sharon H Giordano; Abeena Brewster; Julia Moore; Edgardo Rivera; Gabriel N Hortobagyi; Hai T Tran Journal: Cancer Date: 2011-10-17 Impact factor: 6.860
Authors: Rebecca A Miksad; Vera Zietemann; Raffaella Gothe; Ruth Schwarzer; Annette Conrads-Frank; Petra Schnell-Inderst; Björn Stollenwerk; Uwe Siebert Journal: Int J Technol Assess Health Care Date: 2008 Impact factor: 2.188