Advertisement

Breast Cancer

, Volume 7, Issue 4, pp 380–388 | Cite as

Current perspectives for treatment of Breast Cancer

  • Craig Bunnell
Luncheon Seminar VI

Conclusions

The last 2–3 years have brought significant changes to both the adjuvant and palliative treatment of breast cancer. The addition of paclitaxel to the adjuvant setting has brought the largest increase in benefit from adjuvant therapy since the initial CMF trials in the 1970s. Changes in the schedule of administration of the taxanes in the palliative setting have substantially diminished the toxicity without an apparent compromise in the efficacy of these important agents. The combination of chemotherapy and Herceptin in the first line treatment of metastatic breast cancer has resulted in enhancement of survival of women with advanced disease. In only a few short years, the future for women diagnosed with breast cancer has come to look substantially brighter.

Key words

Breast cancer Taxanes Adjuvant Metastatic Herceptin 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1).
    Nabholtz JM, Gelman K, Bontenbal M,et al: Multicenter, randomized comparative study of two doses of paclitaxel in patients with metastatic breast cancer.J Clin Oncol 14:1858–1867, 1996.PubMedGoogle Scholar
  2. 2).
    Winer E, Berry D, Duggan D,et al: Failure of higher dose paclitaxel to improve outcom in patients with metastatic breast cancer-results from CALGB 9342.Proc Am Soc Clin Oncol 17:101, 1998 (abstract 388).Google Scholar
  3. 3).
    Peretz T, Sulkes A, Chollet P,et al: A multicenter, randomized study of two schedules of paclitaxel in patients with advanced breast cancer.Eur J Cancer 31A(suppl 5): S75, 1995 (abstract 345).CrossRefGoogle Scholar
  4. 4).
    Mamounas E, Brown A, Smith R,et al: Effect of Taxol duration of infusion in advanced breast cancer (ABC): Results from NSABP B-26 trial comparing 3–2 24-hour infusion of high-dose Taxol.Proc Am Soc Clin Oncol 17:101, 1998 (abstract 389).Google Scholar
  5. 5).
    Holmes FA, Valero V, Walters R,et al: Phase III trial of paclitaxel administered over a 3-hour or 96-hour for metastatic breast cancer (MBC).Proc Am Soc Clin Oncol 15:106, 1996 (abstract 91).Google Scholar
  6. 6).
    Holmes FA, Valero V, Buzdar AU,et al: Final results: Randomized phase III trial of paclitaxel by 3-hour versus 96-hour infusion in patients with metastatic breast cancer (MBC). The long and short of it.Proc Am Soc Clin Oncol 17:110, 1998 (abstract 426).Google Scholar
  7. 7).
    Seidman AD, Hochhauser D, Gollub M,et al: 96-hour paclitaxel infusion after progression during short taxane exposure: A phase II pharmacokinetic and pharmacodynamic study in metastatic breast cancer.J Clin Oncol 14:1877–1884, 1996.PubMedGoogle Scholar
  8. 8).
    Nabholz JM, Senn HJ, Bezwoda WR,et al: Prospective randomized trial of docetaxel versus mitomycin plus vinblastine in patients with metastatic breast cancer progressing despite previous anthracycline-containing chemotherapy.J Clin Oncol 17:1413–1424, 1999.Google Scholar
  9. 9).
    Chan S, Friedrichs K, Noel D,et al: A phase III study of Taxotere versus doxorubicin in patients with metastatic breast cancer (MBC) who have failed an alkylating-containing regimen.Breast Cancer Res Treatment 46:23, 1997 (abstract 1).CrossRefGoogle Scholar
  10. 10).
    Fumoleau P, Chevallier B, Kerbrat P,et al: A multicenter phase II study of the efficacy and safety of docetaxel and first-line treatment of advanced breast cancer: Report of the Clinical Screening Group of the EORTC.Ann Oncol 7:165–171, 1996.PubMedGoogle Scholar
  11. 11).
    O’Brien M, Leonard R, Barrett-Lee PJ,et al: Docetaxel in the community setting: An analysis of 377 breast cancer patients treated with docetaxel (Taxotere®) in the UK.Ann Oncol 10:205–210, 1999.PubMedCrossRefGoogle Scholar
  12. 12).
    Trudeau ME, Eisenhauer EA, Higgins BP,et al: Docetaxel in patients with metastatic breast cancer: A phase II study of the National Cancer Institute of Canada-Clinical Trials Group.J Clin Oncol 14:422–428, 1996.PubMedGoogle Scholar
  13. 13).
    Archer CD, Lowdell C, Sinnett HD,et al: Docetaxel: response in patients who have received at least two prior chemotherapy regimens for metastatic breast cancer.Eur J Cancer 34:816–819, 1998.PubMedCrossRefGoogle Scholar
  14. 14).
    Ravdin PM, Burris HA, Cook G,et al: Phase II trial of docetaxel in advanced anthracycline-resistant or an-thracenedione-resistant breast cancer.J Clin Oncol 13:2879–2885, 1995.PubMedGoogle Scholar
  15. 15).
    Hudis CA, Seidman AD, Crown JPA,et al: Phase II and pharmacological study of docetaxel as initial chemotherapy for metastatic breast cancer.J Clin Oncol 14:58–65, 1996.PubMedGoogle Scholar
  16. 16).
    Seidman AD, Hudis CA, Albanel J,et al: Dose-dense therapy with weekly 1-hour paclitaxel infusions in the treatment of metastatic breast cancer.J Clin Oncol 16:3353–3361, 1998.PubMedGoogle Scholar
  17. 17).
    Loesch D, Robert N, Dakhil S,et al: Phase II trial of weekly Taxol, 5-fluorouracil and leucovorin regimen in patients with metastatic breast cancer: An update.Proc Am Soc Clin Oncol 18:117, 1999 (abstract 445).Google Scholar
  18. 18).
    Perez EA, Irwin DH, Patel R,et al: A large phase II trial of paclitaxel administered as a weekly 1-hour infusion in patients with metastatic breast cancer.Proc Am Soc Clin Oncol 18:126, 1999 (abstract 480).Google Scholar
  19. 19).
    Fornier M, Seidman AD, Esteva FJ,et al: Weekly Herceptin plus 1-hour Taxol: phase II study in HER2-overexpressing and non-overexpressing metastatic breast cancer.Proc Am Soc Clin Oncol 18:126, 1999 (abstract 482).Google Scholar
  20. 20).
    Breier S, Lebedinsky C, Pelayes L,et al: Phase I/II weekly paclitaxel 80 mg/m2 in pre-treated patients with breast or ovarian cancer.Proc Am Soc Clin Oncol 16:163, 1997 (abstract 568).Google Scholar
  21. 21).
    Burstein HJ, Younger J, Bunnell CA,et al: Weekly docetaxel (Taxotere) for metastatic breast cancer: A phase II trial.Proc Am Soc Clin Oncol 18:127, 1999 (abstract 484).Google Scholar
  22. 22).
    Loffler TM, Freund W, Droge C,et al: Activity of weekly Taxotere in patients with metastatic breast cancer.Proc Am Soc Clin Oncol 17:113, 1998 (abstract 435).Google Scholar
  23. 23).
    Climent MA, Ruiz A, Llombart-Cussac A,et al: Weekly docetaxel in patients with advanced malignancies. Toxicity profile and activity results.Proc Am Soc Clin Oncol 18:119, 1999 (abstract 453).Google Scholar
  24. 24).
    Piccart MJ, Klijn J, Paridaens R,et al: Corticosteroids significantly delay the onset of docetaxel-induced fluid retention: Final results of a randomized study of the European Organization for Research and Treatment of Investigational Drug Branch for Breast Cancer.J Clin Oncol 15:3149–3155, 1997.PubMedGoogle Scholar
  25. 25).
    Robert N, Loesch D, Dakhil S,et al: Phase II trial of weekly Taxotere, 5-fluorouracil, and leucovorin in patients with advanced breast cancer.Proc Am Soc Clin Oncol 18:119, 1999 (abstract 451).Google Scholar
  26. 26).
    Cobleigh MA, Vogel CL, Tripathy D,et al: Multinational study of the efficacy and safety of humanized anti-HER2 monoclonal antibody in women who have HER2-overexpressing metastatic breast cancer that has progressed after chemotherapy for metastatic disease.J Clin Oncol 17:2639–2648, 1999.PubMedGoogle Scholar
  27. 27).
    Slamon D, Leyland-Jones B, Shak S,et al: The addition of Herceptin (humanized anti-HER2 antibody) to first-line chemotherapy for HER2-overexpressing metastatic breast cancer (HER2+ MBC) markedly increases anti-cancer activity: A randomized, multinational controlled phase II trial.Proc Am Soc Clin Oncol 17:98, 1998 (abstract 377).Google Scholar
  28. 28).
    Norton L, Slamon D, Leyland-Jones B,et al: Overall survival (OS) advantage to simultaneous chemotherapy (CRx) plus the humanized anti-HER2 monoclonal antibody Herceptin in HER2-overexpressing (HER2+) metastatic breast cancer (MBC).Proc Am Soc Clin Oncol 18:127, 1999 (abstract 483).Google Scholar
  29. 29).
    Former M, Seidman AD, Esteva FJ,et al: Weekly Herceptin and 1 hour taxol: Phase II study in HER2 overexpressing and non-overexpressing metastatic breast cancer.Proc Am Soc Clin Oncol 18:126a, 1999 (abstract 482).Google Scholar
  30. 30).
    Henderson IC, Berry D, Demetri G,et al: Improved disease-free (DFS) and overall survival (OS) from the addition of sequential paclitaxel (T) but not from the escalation of doxorubicin (A) dose level in the adjuvant chemotherapy of patients (PTS) with node-positive primary breast cancer (BC).Proc Am Soc Clin Oncol 17:101a, 1998 (abstract 390).Google Scholar
  31. 31).
    Taxol® (paclitaxel) injection official prescribing information, Bristol-Myers Squibb Company, Princeton, NJ, 1999.Google Scholar

Copyright information

© The Japanese Breast Cancer Society 2000

Authors and Affiliations

  • Craig Bunnell
    • 1
  1. 1.Department of Adult OncologyDana-Farber Cancer Institute and Harvard Medical SchoolUSA

Personalised recommendations