WEDNESDAY, April 16 (HealthDay News) -- Women who take the drug
Taxol weekly after receiving chemotherapy for 12 weeks live longer
and live longer without a recurrence of their breast cancer,
compared to women who take four taxol treatments every three
weeks.
The study also evaluated another drug in the same family, called
Taxotere (docetaxel), but found that weekly Taxol (paclitaxel) was
more effective.
"The findings suggest that weekly Taxol for 12 weeks is more
effective than four cycles of Taxol and should be considered a new
standard," said study author Dr. Joseph A. Sparano. The findings
are detailed in the April 17 issue of the
New England Journal of Medicine.
Prior to this study, four cycles of Taxol was considered the
standard, although many oncologists were administering the drug
weekly.
"We have been using Taxol weekly for at least a year," said Dr.
Kumud Tripathy, a clinical assistant professor of internal medicine
at Texas A & M Health Science Center College of Medicine and an
oncologist with the Bryan-College Station Cancer Clinic.
Women with breast cancer who receive drugs known as taxanes
after standard chemotherapy have a substantially reduced risk of
recurrence and of death. The other taxane, Taxotere (docetaxel) is
more potent than Taxol.
About a decade ago, a study showed that adding Taxol to standard
chemo reduced the risk of breast cancer recurrence. The drug was
subsequently approved in the United States, with the standard of
care being four doses once every three weeks.
A later study showed that giving the same dosage every two weeks
was more effective than every three weeks, so that became common
practice.
In the meantime, questions were raised as to whether taxanes
were effective for the most common type of breast cancer, or that
which is hormone-receptor positive and HER2-negative.
"It raised a lot of concerns," said Sparano, director of breast
evaluation center at Montefiore-Einstein Cancer Center in New York
City. "People were saying, 'Wait a minute. We thought Taxol was
very effective, and maybe it's not as effective as we thought, and
are we treating people unnecessarily?'"
Here, Sparano and his colleagues compared the effectiveness of
giving standard chemo (doxorubicin and cyclophosphamide at
three-week intervals) plus four cycles or doses of Taxol every
three weeks versus every week for 12 doses at a lower dose. They
also compared Taxol with Taxotere (four cycles every three weeks)
or Taxotere given either every three weeks for four treatments or
weekly for 12 treatments. The study involved almost 5,000
women.
There were no significant differences in survival between those
treated with Taxol and those treated with Taxotere or between the
groups treated weekly or every three weeks.
There was no indication that weekly Taxol was less effective in
women with hormone-receptor-positive, HER2-negative breast
cancer.
"Taxol is effective in patients with one or more common subtypes
[of breast cancer] and, if it is going to be used in that
population, should be delivered weekly for 12 weeks rather than
every three weeks for four treatments," Sparano said.
More information
The
National Cancer Institute has more on breast
cancer.