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| |  ASCO: Weekly Paclitaxel Better Than Standard Dosage For Breast Cancer Treatment By Charles Bankhead Special to DG news
SAN FRANCISCO, CA -- May 15, 2001 -- Weekly paclitaxel results in a superior pathologic complete response rate compared to conventional dosing when used in neoadjuvant chemotherapy for breast cancer, preliminary results from an ongoing randomized clinical trial indicate. A regimen of weekly paclitaxel plus standard FAC chemotherapy (5-fluorouracil, adriamycin, and cyclophosphamide) resulted in pathologic complete response rates in excess of 30 percent regardless of nodal status. This compared to 13-19 percent with paclitaxel given every three weeks with FAC, as reported at the American Society of Clinical Oncology (ASCO) meeting. "This is still an ongoing study, so the data are not yet applicable to the general population, but we think the paclitaxel schedule is important," said Marjorie Green, MD, a medical oncologist at the University of Texas M.D. Anderson Cancer Center in Houston, Texas. "The weekly schedule looks like it will be superior," she explained. "We hope the survival data will confirm this, because in general pathologic complete response has been equivalent to survival. Since the pathologic complete response rate is so much higher with the weekly paclitaxel schedule, we hope survival also will be higher." Dr. Green reported findings from 163 of 198 breast cancer patients enrolled in a randomized comparison of weekly paclitaxel versus paclitaxel given every three weeks. Evaluable patients included 68 who had metastatic spread to the lymph nodes and 89 who had negative nodes. Node-positive patients randomized to weekly paclitaxel received 150 mg/m2 weekly for three weeks, followed by a one-week break, repeated for four cycles. Node-negative patients received 80 mg/m2 for 12 consecutive weeks. All patients randomized to conventional paclitaxel dosing received 225 mg/m2 every three weeks. Patients in both randomized treatment groups received four cycles of conventionally dosed FAC combination chemotherapy, administered every three weeks. Weekly paclitaxel resulted in clinical complete responses in 38.2 percent of node-positive patients and 43.5 percent of node-negative patients, compared to 19.4 percent of node-positive patients and 28.9 percent of node-negative patients who received paclitaxel every three weeks. About 41 percent of patients in the weekly paclitaxel group had partial responses, irrespective of nodal status, versus 41.7 percent of node-positive and 53.3 percent of node-negative patients randomized to paclitaxel every three weeks. Pathologic complete responses occurred in 32.4 percent and 30.4 percent of node-positive and node-negative patients who received weekly paclitaxel, respectively. That compared with pathologic complete response rates of 19.4 percent and 13.3 percent for node-positive and node-negative patients who received conventional paclitaxel dosing (p=0.04).
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