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Adjuvant Chemo with Taxanes Studied in Breast Cancer

Improved survival seen with weekly paclitaxel

WEDNESDAY, April 16 (HealthDay News) -- In the treatment of breast cancer, weekly dosing of paclitaxel after a standard doxorubicin-cyclophosphamide chemotherapy regimen may improve survival, according to an article published in the April 17 issue of the New England Journal of Medicine.

Joseph A. Sparano, M.D., of the Eastern Cooperative Oncology Group in Philadelphia, and colleagues randomly assigned 4,950 women with lymph node-positive or high-risk node-negative breast cancer to receive four cycles of intravenous doxorubicin and cyclophosphamide followed by either standard therapy with paclitaxel every three weeks for four cycles, paclitaxel given weekly for 12 cycles, docetaxel every three weeks for four cycles, or docetaxel weekly for 12 cycles.

Compared to patients receiving paclitaxel every three weeks, disease-free survival was improved in patients receiving weekly paclitaxel (odds ratio 1.27), docetaxel every three weeks (OR, 1.23) and weekly docetaxel (OR, 1.09). Weekly paclitaxel was also associated with improved overall survival (OR, 1.32) compared to paclitaxel dosed every three weeks. Neuropathy was more common with weekly paclitaxel than paclitaxel every three weeks (27 percent versus 20 percent).

Hormone receptor status did not appear to affects results. "We found no evidence that women with hormone receptor-positive, HER2-negative breast cancer derived less benefit than those with breast cancer negative for hormone receptors or positive for HER2," the authors conclude.

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