Docetaxel and Doxorubicin Compared With Doxorubicin and Cyclophosphamide as First-Line Chemotherapy for Metastatic Breast Cancer: Results of a Randomized, Multicenter, Phase III Trial
| Autor: | Tadeuz Pienkowski, Miguel Martin, Nacer Azli, Stephen Chan, Jean-Marc Nabholtz, Ian Kennedy, Daniel Campos, Maciej Krzakowski, Robert Leonard, Tamás Pintér, J. Zaluski, Michael Murawsky, Pierre Pouillart, Alessandro Riva, Daniel A. Vorobiof, Carla I. Falkson, János Szántó |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Randomization Paclitaxel Cyclophosphamide Health Status medicine.medical_treatment Breast Neoplasms Docetaxel Gastroenterology Disease-Free Survival Ventricular Dysfunction Left chemistry.chemical_compound Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Doxorubicin Aged Neoplasm Staging Chemotherapy Antibiotics Antineoplastic business.industry Middle Aged medicine.disease Antineoplastic Agents Phytogenic Hematologic Diseases Survival Analysis Metastatic breast cancer Nitrogen mustard Surgery Treatment Outcome Oncology chemistry Disease Progression Quality of Life Female Taxoids business medicine.drug |
| Zdroj: | Journal of Clinical Oncology. 21:968-975 |
| ISSN: | 1527-7755 0732-183X |
| DOI: | 10.1200/jco.2003.04.040 |
| Popis: | Purpose: This randomized, multicenter, phase III study compared doxorubicin and docetaxel (AT) with doxorubicin and cyclophosphamide (AC) as first-line chemotherapy (CT) in metastatic breast cancer (MBC). Patients and Methods: Patients (n = 429) were randomly assigned to receive doxorubicin 50 mg/m2 plus docetaxel 75 mg/m2 (n = 214) or doxorubicin 60 mg/m2 plus cyclophosphamide 600 mg/m2 (n = 215) on day 1, every 3 weeks for up to eight cycles. Results: Time to progression (TTP; primary end point) and time to treatment failure (TTF) were significantly longer with AT than AC (median TTP, 37.3 v 31.9 weeks; log-rank P = .014; median TTF, 25.6 v 23.7 weeks; log-rank P = .048). The overall response rate (ORR) was significantly greater for patients taking AT (59%, with 10% complete response [CR], 49% partial response [PR]) than for those taking AC (47%, with 7% CR, 39% PR) (P = .009). The ORR was also higher with AT in patients with visceral involvement (58% v 41%; liver, 62% v 42%; lung, 58% v 35%), three or more organs involved (59% v 40%), or prior adjuvant CT (53% v 41%). Overall survival (OS) was comparable in both arms. Grade 3/4 neutropenia was frequent in both groups, although febrile neutropenia and infections were more frequent for patients taking AT (respectively, 33% v 10%, P < .001; 8% v 2%, P = .01). Severe nonhematologic toxicity was infrequent in both groups, including grade 3/4 cardiac events (AT, 3%; AC, 4%). Conclusion: AT significantly improves TTP and ORR compared with AC in patients with MBC, but there is no difference in OS. AT represents a valid option for the treatment of MBC. |
| Databáze: | OpenAIRE |
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