Docetaxel and Paclitaxel in the Treatment of Breast Cancer: A Review of Clinical Experience

Abstract

Abstract Learning Objectives After completing this course, the reader will be able to: Describe randomized trial data from studies evaluating taxanes in anthracycline-naïve or anthracycline-pretreated metastatic breast cancer patients. Discuss recent findings of randomized trials evaluating docetaxel as neoadjuvant therapy. Compare and contrast efficacy end point data from three adjuvant taxane trials with mature results. Access and take the CME test online and receive 1 hour of AMA PRA category 1 credit at CME.TheOncologist.com In the 10 years since their initial licensing in Europe, the taxanes, paclitaxel and docetaxel, have emerged as fundamental drugs in the treatment of breast cancer. Clinically meaningful benefits were first shown in the metastatic setting, and large-scale exploration of their roles in the adjuvant therapy of early-stage disease is ongoing. Benefits have been seen in the neoadjuvant setting as well, mainly with docetaxel. This paper reviews the current roles of the taxanes in the treatment of metastatic and early-stage breast cancer. Also addressed are outstanding issues involving optimal dosing and sequencing, as well as a discussion of the relative merits of each agent in this setting. Clinicians should choose a taxane-based regimen for their patients with breast cancer based on consideration of the pharmacokinetics, clinical activity, and dosing schedule that best meets the patients' needs. At the current time, the pharmacokinetic profile, consistent positive clinical results, and convenience of an intermittent, short-infusion schedule have made docetaxel the preferred taxane for many clinicians treating patients with breast cancer.