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Title: | Taxanes alone or in combination with anthracyclines as first-line therapy of patients with metastatic breast cancer | Authors: | Piccart-Gebhart, Martine J. BURZYKOWSKI, Tomasz BUYSE, Marc Sledge, George Carmichael, James Luck, Hans-Joachim Mackey, John R. Nabholtz, Jean-Marc Paridaens, Robert Biganzoli, Laura Jassem, Jacek Bontenbal, Marijke Bonneterre, Jacques Chan, Stephen Basaran, Gul Atalay Therasse, Patrick |
Issue Date: | 2008 | Publisher: | AMER SOC CLINICAL ONCOLOGY | Source: | JOURNAL OF CLINICAL ONCOLOGY, 26(12). p. 1980-1986 | Abstract: | Purpose Taxanes (paclitaxel or docetaxel) have been sequenced or combined with anthracyclines (doxorubicin or epirubicin) for the first-line treatment of advanced breast cancer. This meta-analysis uses data from all relevant trials to detect any advantages of taxanes in terms of tumor response, progression-free survival (PFS), and survival. Patients and Methods Individual patient data were collected on eight randomized combination trials comparing anthracyclines + taxanes (+ cyclophosphamide in one trial) with anthracyclines + cyclophosphamide (+ fluorouracil in four trials), and on three single-agent trials comparing taxanes with anthracyclines. Combination trials included 3,034 patients; single-agent trials included 919 patients. Results Median follow-up of living patients was 43 months, median survival was 19.3 months, and median PFS was 7.1 months. In single-agent trials, response rates were similar in the taxanes (38%) and in the anthracyclines (33%) arms (P =.08). The hazard ratios for taxanes compared with anthracyclines were 1.19 (95% CI, 1.04 to 1.36; P =.011) for PFS and 1.01 (95% CI, 0.88 to 1.16; P = .90) for survival. In combination trials, response rates were 57% (10% complete) in taxane-based combinations and 46% (6% complete) in control arms (P <.001). The hazard ratios for taxane-based combinations compared with control arms were 0.92 (95% CI, 0.85 to 0.99; P = .031) for PFS and 0.95 (95% CI, 0.88 to 1.03; P = .24) for survival. Conclusion Taxanes were significantly worse than single-agent anthracyclines in terms of PFS, but not in terms of response rates or survival. Taxane-based combinations were significantly better than anthracycline-based combinations in terms of response rates and PFS, but not in terms of survival. | Notes: | Inst Jules Bordet, B-1000 Brussels, Belgium. European Org Res Treatment Canc, Brussels, Belgium. Hasselt Univ, Diepenbeek, Belgium. Int Inst Drug Dev, Louvain, Belgium. Univ Hosp Gasthuisberg, B-3000 Louvain, Belgium. Indiana Univ Purdue Univ, Indianapolis, IN 46202 USA. Astra Zeneca, Macclesfield, Cheshire, England. City Hosp Nottingham, Nottingham, England. Hannover Med Sch, D-30623 Hannover, Germany. Univ Alberta, Edmonton, AB, Canada. Breast Canc Res Inst Prandie, Valojoulx, France. Ctr Oscar Lambret, F-59020 Lille, France. Hosp Prato, Prato, Italy. Med Univ Gdansk, Gdansk, Poland. Univ Med Ctr, Erasmus MC, Rotterdam, Netherlands. Marmara Univ Hosp, Istanbul, Turkey.Piccart-Gebhart, MJ, Inst Jules Bordet, 121 Blvd Waterloo, B-1000 Brussels, Belgium.martine.piccart@bordet.be | Document URI: | http://hdl.handle.net/1942/8257 | ISSN: | 0732-183X | e-ISSN: | 1527-7755 | ISI #: | 000255054700014 | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2009 |
Appears in Collections: | Research publications |
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TomaszBurzykowski5.pdf | 321.75 kB | Adobe PDF | View/Open |
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