Dose-dense adjuvant Taxotere containing regimens for breast cancer
Posted Jun 24 2009 7:01pm
Dose dense Taxotere after CA chemotehrapy has not beenstudied in dose dense fashion.
Dose dense therapy has ben studied in the metastatic, adjuvant and neoadjuvant setting. To my knowledge, Taxotere there is only one study in the adjuvant setting in dose dense fashion. A European study using the TEC regimen concluded: "Dose-dense regimens yield more frequent and severe nonhematological toxic effects than standard dose TEC regimen. Though grade 4 toxicity rates appear acceptable with the TEC regimen, the incidence of grade 3–4 events makes it difficult to recommend either dose-dense regimen for further investigation." However, in 2008, a phase II study did look at the Ac + Taxotere dose dense regimen.
Fifty-six patients with axillary node-positive, nonmetastatic breast cancer were randomly assigned either to group A (docetaxel [DOC] 75 mg/m2 intravenously [IV] every 14 days for four cycles followed by doxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2 [AC] IV every 14 days for four cycles); or to group B (AC followed by DOC) at the identical doses and schedule. Pegfilgrastim 6 mg subcutaneous injection was administered 1 day after the chemotherapy in all treatment cycles. The primary objective was to administer DOC without dose reductions or delays before or after AC and calculate the relative dose intensity (RDI) of DOC and AC. The administration of DOC before AC resulted in fewer DOC dose reductions and a higher RDI than the reverse sequence. IT concluded that larger trials evaluating the sequence of DOC before anthracyclines are justified. To my knowledge there are no studied using doise dense AC followed by q 3 weekly Taxotere. It should be considered experimental.
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