Weekly docetaxel in metastatic breast cancer patients: No superior benefits compared to three-weekly docetaxel
| Autor: | Gert A. van Deijk, Linda de Munck, Anneke M. Westermann, Willem M. Smit, Geert-Jan Creemers, Carolien P. Schröder, Willemijn Vader, Zoran Erjavec, Pax H.B. Willemse, Aart van Bochove, Hiltje de Graaf, Jacqueline M. Stouthard |
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| Přispěvatelé: | Cancer Center Amsterdam, Oncology, Faculteit Medische Wetenschappen/UMCG, Guided Treatment in Optimal Selected Cancer Patients (GUTS) |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Oncology Cancer Research medicine.medical_specialty Time Factors Efficacy EUROPEAN-ORGANIZATION Antineoplastic Agents Breast Neoplasms Docetaxel Drug Administration Schedule Breast cancer Phase III Quality of life QUALITY-OF-LIFE Internal medicine medicine Humans Neoplasm Metastasis Treatment regimen ELDERLY-PATIENTS Aged Proportional Hazards Models Weekly Univariate analysis business.industry INFUSION Hazard ratio Middle Aged Tolerability Randomised multicenter medicine.disease Metastatic breast cancer Surgery Treatment Outcome Multivariate Analysis Quality of Life PHASE-II Metastatic Female Taxoids TRIAL business Febrile neutropenia medicine.drug |
| Zdroj: | European journal of cancer (Oxford, England, 47(9), 1355-1362. Elsevier Limited European Journal of Cancer, 47(9), 1355-1362. ELSEVIER SCI LTD |
| ISSN: | 0959-8049 |
| Popis: | Background: In anthracycline-pretreated metastatic breast cancer (MBC) patients, it is unknown whether weekly single-agent docetaxel is preferable to 3-weekly docetaxel regarding its toxicity and efficacy profile.Patients and methods: In this multicenter, randomised, open-label phase III trial, 162 patients were randomised to weekly docetaxel (group A) or 3-weekly docetaxel (group B). The primary end-point was tolerability; secondary end-points were efficacy and quality of life (QoL).Results: Group A (weekly docetaxel, n = 79) experienced less haematological toxicity, with just 1.3% versus 16.9% febrile neutropenia in group B (3-weekly docetaxel, n = 77) (p = 0.001). Not this difference, but fatigue and general malaise foremost led to more patient withdrawals in group A (24 versus 12 patients, p = 0.032), less patients completing treatment (29 versus 43 patients, p = 0.014) and reduced dose-intensity (15.6 versus 26 mg/m(2)/week, 58% versus 70% of projected dose, p = 0.017). As a result, 3-weekly docetaxel was related to better overall survival in multivariate analysis (hazard ratio 0.70, p = 0.036), although in univariate analysis efficacy was similar in both groups. Reported QoL was similar in both groups, but less effective treatment with more general toxicity led to less completed QoL forms in group A (65.4% versus 50%, p = 0.049).Conclusion: Weekly docetaxel is less well tolerated than a 3-weekly schedule, due to more non-haematological toxicity, despite less febrile neutropenia. Also, no efficacy benefits can be demonstrated for weekly docetaxel, which may even be inferior based on multivariate analysis. Therefore, a 3-weekly schedule should be preferred in the setting of MBC. (C) 2011 Elsevier Ltd. All rights reserved. |
| Databáze: | OpenAIRE |
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