|
A correction has been published: N Engl J Med 2008;359(1):106.
|
Background We compared the efficacy of two different taxanes, docetaxel and paclitaxel, given either weekly or every 3 weeks, in the adjuvant treatment of breast cancer.
Methods We enrolled 4950 women with axillary lymph node–positive or high-risk, lymph node–negative breast cancer. After randomization, all patients first received 4 cycles of intravenous doxorubicin and cyclophosphamide at 3-week intervals and were then assigned to intravenous paclitaxel or docetaxel given at 3-week intervals for 4 cycles or at 1-week intervals for 12 cycles. The primary end point was disease-free survival.
Results As compared with patients receiving standard therapy (paclitaxel every 3 weeks), the hazard ratio for disease-free survival was 1.27 among those receiving weekly paclitaxel (P=0.006), 1.23 among those receiving docetaxel every 3 weeks (P=0.02), and 1.09 among those receiving weekly docetaxel (P=0.29) (with an hazard ratio >1 favoring the groups receiving experimental therapy). As compared with standard therapy, weekly paclitaxel was also associated with improved survival (hazard ratio, 1.32; P=0.01). An exploratory analysis of a subgroup of patients whose tumors expressed no human epidermal growth factor receptor type 2 protein found similar improvements in disease-free and overall survival with weekly paclitaxel treatment, regardless of hormone-receptor expression. Grade 2, 3, or 4 neuropathy was more frequent with weekly paclitaxel than with paclitaxel every 3 weeks (27% vs. 20%).
Conclusions Weekly paclitaxel after standard adjuvant chemotherapy with doxorubicin and cyclophosphamide improves disease-free and overall survival in women with breast cancer. (ClinicalTrials.gov number, NCT00004125
[ClinicalTrials.gov]
.)
Source Information
From the Eastern Cooperative Oncology Group, Philadelphia (J.A.S., M.W., T.S., A.C.W., G.W.S., W.C.W., N.E.D.); the Southwest Oncology Group, Ann Arbor, MI (S.M.); the Cancer and Leukemia Group B, Chicago (V.J.); and the North Central Cancer Treatment Group, Rochester, MN (E.A.P.).
Address reprint requests to Dr. Sparano at Montefiore Medical Center–Weiler Division, 1825 Eastchester Rd., 2 South, Rm. 47, Bronx, NY 10461, or at jsparano{at}montefiore.org.
Related Letters:
Weekly Paclitaxel in the Adjuvant Treatment of Breast Cancer
Tsubokura M., Kami M., Komatsu T., Aksoy S., Dizdar O., Altundag K., Sparano J. A.
Extract |
Full Text |
PDF
N Engl J Med 2008;
359:310-311, Jul 17, 2008.
Correspondence
This article has been cited by other articles:
HOME | SUBSCRIBE | SEARCH | CURRENT ISSUE | PAST ISSUES | COLLECTIONS | PRIVACY | HELP | beta.nejm.org Comments and questions? Please contact us. The New England Journal of Medicine is owned, published, and copyrighted © 2008 Massachusetts Medical Society. All rights reserved. |
Previous
