Cancer Research Lab

Treatment with docetaxel after doxorubicin therapy appears to increase disease-free survival in women with lymph node-positive breast cancer, according to study findings in the Journal of the National Cancer Institute for January 16.

The study involved 2887 patients who were randomized to receive standard CMF chemotherapy preceded by doxorubicin (sequential control), doxorubicin plus cyclophosphamide (concurrent control), doxorubicin and then docetaxel (sequential docetaxel), or doxorubicin plus docetaxel (concurrent docetaxel).

The primary analysis was to take place after 1215 disease-free survival (DFS) events had occurred, but the relapse rate was lower than anticipated, so the analysis was performed after 732 events had been logged during a 5-year period.

The 5-year DFS rate in the control groups was 73%, lead author Dr. Prudence Francis, from the Peter MacCallum Cancer Centre in Melbourne, Australia, and colleagues note.

With sequential docetaxel, DFS increased slightly, but significantly to 78% (p = 0.05). DFS in the concurrent docetaxel group — 74% — however, was not significantly different from that achieved in the control groups.

No significant difference in overall survival was seen between the groups.

“Important differences may be related to doxorubicin and docetaxel scheduling, with sequential but not concurrent administration appearing to produce better DFS,” the authors conclude.