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Abstract
Among the novel chemotherapeutic drugs introduced in the 1990s, the taxanes have emerged
as the most powerful compounds in breast cancer. Paclitaxel and docetaxel have been
evaluated in the metastatic setting before proceeding with adjuvant trials. The adjuvant
strategies of development of both taxanes have been different, mostly as a result
of pharmacokinetic differences and dose-schedule issues. As a consequence, paclitaxel
was studied nearly exclusively in sequential programs such as AC (doxorubicin/cyclophosphamide)
followed by paclitaxel or doxorubicin, followed by paclitaxel, followed by cyclophosphamide.
In contrast, docetaxel has been investigated in sequence (AC followed by docetaxel)
and in combination chemotherapy (doxorubicin/docetaxel and docetaxel/doxorubicin/cyclophosphamide).
Available results of large-scale phase III trials confirm that the taxanes have the
potential to change the natural history of early-stage breast cancer. It is becoming
clear that sequential chemotherapy and polychemotherapy approaches with taxanes are
to be considered in the treatment of patients with node-positive breast cancer. Further
results are eagerly awaited to fully understand the role of taxanes and to optimize
their impact on early-stage breast cancer. It is our opinion that the real pending
issue is no longer whether taxanes will make a difference in the adjuvant setting
(the answer is most likely yes), but the definition of their optimal strategic use
for maximum patient benefit.
Key words
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Article info
Publication history
Accepted:
August 10,
2003
Received in revised form:
August 8,
2003
Received:
April 25,
2003
Identification
Copyright
© 2003 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
