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Improved Breast Cancer Survival with Docetaxel

Treatment more effective when given sequentially

FRIDAY, Jan. 11 (HealthDay News) -- Adding docetaxel to doxorubicin plus adjuvant chemotherapy improves five-year disease-free survival in patients with breast cancer, particularly if given sequentially rather than concurrently, according to the results of a study published in the Jan. 16 issue of the Journal of the National Cancer Institute.

Prudence Francis, from the Peter MacCallum Cancer Centre in Melbourne, Australia, and colleagues randomly assigned 2,887 patients with lymph node-positive breast cancer to: doxorubicin followed by adjuvant chemotherapy (sequential control); doxorubicin plus cyclophosphamide, followed by adjuvant chemotherapy (concurrent control); doxorubicin followed by docetaxel, followed by adjuvant chemotherapy (sequential docetaxel); or doxorubicin plus docetaxel, followed by adjuvant chemotherapy (concurrent docetaxel).

After five years, the researchers found that the control groups had a disease-free survival of 73 percent, which was improved by docetaxel treatment (hazard ratio 0.86). However, disease-free survival was better in the sequential docetaxel group than the concurrent docetaxel group (hazard ratio 0.83) and the sequential control group (hazard ratio 0.79).

"Incorporating docetaxel into anthracycline-based chemotherapy resulted in an improvement in disease-free survival that was of borderline statistical significance," Francis and colleagues conclude. "However, important differences may be related to doxorubicin and docetaxel scheduling, with sequential but not concurrent administration, appearing to produce better disease-free survival than anthracycline-based chemotherapy."

Multiple study authors report financial affiliation with Sanofi-Aventis, and one of the study authors is a member of the speakers bureau for Roche.

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