According to results recently published in the Journal of Clinical Oncology, the addition of Taxotere® (docetaxel) to doxorubicin and cyclophosphamide improves anti-cancer responses when used as neoadjuvant therapy in operable breast cancer.

Breast cancer is diagnosed in approximately 200,000 women annually in the United States alone. Chemotherapy remains as part of treatment in patients with operable breast cancer; however, the schedule of chemotherapy and surgery in relation to each other are being evaluated in patients with this disease. Neoadjuvant therapy, or therapy prior to surgery, is a strategy used to shrink the cancer prior to its surgical removal for more complete removal of the cancer and immediate systemic (full body) effects. Results from clinical trials have demonstrated that neoadjuvant therapy provides the same survival as chemotherapy delivered after surgery (adjuvant therapy) in operable breast cancer but leads to higher rates of breast-conserving surgery. Researchers are evaluating optimal neoadjuvant chemotherapy regimens to continue improving long-term outcomes for patients with operable breast cancer.

Researchers affiliated with the National Surgical Adjuvant Breast and Bowel Project Protocol B-27 recently conducted a clinical trial evaluating neoadjuvant chemotherapy in patients with operable (stages I-III) breast cancer. This trial involved over 2,000 women who were treated with different regimens and compared. All patients were initially treated with neoadjuvant chemotherapy consisting of the common regimen referred to as AC (doxorubicin plus cyclophosphamide). One group of patients was treated only with neoadjuvant AC followed by surgery (group I), a second group was treated with neoadjuvant AC plus Taxotere® followed by surgery (group II), and a third group was treated with neoadjuvant AC followed by surgery and then Taxotere® (group III).

The overall anti-cancer response rates at the time of surgery were 91% for patients in group II, and 85.5% for those in groups I and III. Of the patients in group II who did not achieve a complete disappearance of detectable cancer (complete response) following neoadjuvant AC, 43% achieved a complete response following treatment with neoadjuvant Taxotere®. In addition, patients in group II who did not achieve an anti-cancer response following AC, 53% had an anti-cancer response following treatment with Taxotere®. The rate of negative axillary nodes (no cancer in lymph nodes under the armpit) was increased from 51% of women following neoadjuvant AC, to 58% of women following treatment with neoadjuvant Taxotere®.

The researchers concluded that the addition of Taxotere® to AC as neoadjuvant therapy in the treatment of operable breast cancer appears to increase the rates of anti-cancer responses. Longer follow-up is necessary to determine if these results will lead to improved long-term survival. Patients with operable breast cancer who are considering neoadjuvant chemotherapy may wish to speak with their physician about the risks and benefits of the addition to Taxotere® to a neoadjuvant regimen or the participation in a clinical trial evaluating novel therapeutic approaches. Two sources of information regarding ongoing clinical trials are the National Cancer Institute ( cancer.gov) and www.cancerconsultants.com Personalized clinical trial searches are also performed on behalf of patients at cancerconsultants.com.

Reference: Bear HD, Anderson S, Brown A, et al. The Effect on Tumor Response of Adding Sequential Preoperative Docetaxel to Preoperative Doxorubicin and Cyclophosphamide: Preliminary Results From National Surgical Adjuvant Breast And Bowel Project Protocol B-27. Journal of Clinical Oncology. 2003;21:4165-4174.