Improvement of safety profile of docetaxel by weekly administration in patients with metastatic breast cancer

Onkologie. 2007 Sep;30(8-9):436-41. doi: 10.1159/000104415. Epub 2007 Sep 7.

Abstract

Background: This is a retrospective cohort study on the safety and efficacy profiles of weekly docetaxel at varying doses in patients with pretreated metastatic breast cancer.

Patients and methods: Twenty-five anthracycline-pretreated patients received docetaxel administered on a weekly basis, as a one-hour infusion, at various dosage levels (25, 30, 35, 40 mg/m2) depending on their baseline Karnofsky index. Each 8-week cycle consisted of 6 weeks of drug infusion, followed by a 2-week rest period.

Results: Of the 25 patients investigated, none achieved complete response (CR), while 9 patients showed partial response (PR), which corresponds to an overall response rate of 36%. Five patients (20%) maintained stable disease (SD), whereas 11 patients (44%) suffered tumor progression (PD) during treatment. Clinical response (defined as PR+SD) was achieved in 14 patients (56%). Median time to progression was 231 days (95% CI, 187-275). The baseline Karnofsky index was 87% +/- 9% (range: 70-100). Patients pretreated with anthracyclines only tended to have a better response than anthracycline/paclitaxel-pretreated patients (n = 6, p = 0.054). Higher dosages were associated with neurotoxicity, skin/nail toxicity, leukopenia, nausea/vomiting, fatigue/asthenia, peripheral edema, but not with diarrhea and alopecia. The cumulative dose per patient was largest for a weekly docetaxel dosage of 35 mg/m2 and almost as large for 30 mg/m2.

Conclusion: Balancing toxicity vs. efficacy/cumulative dosage delivered, our results support weekly administration of docetaxel at dosages of 30-35 mg/m2 in metastatic breast cancer. Response in patients pretreated with anthracyclines and taxanes may be poorer than in those pretreated with anthracyclines only.

MeSH terms

  • Aged
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents / adverse effects*
  • Breast Neoplasms / drug therapy*
  • Clinical Trials as Topic
  • Docetaxel
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule*
  • Female
  • Humans
  • Leukopenia / chemically induced
  • Leukopenia / prevention & control
  • Lymphatic Metastasis
  • Middle Aged
  • Nausea / chemically induced
  • Nausea / prevention & control
  • Neoplasm Metastasis / drug therapy*
  • Retrospective Studies
  • Taxoids / administration & dosage*
  • Taxoids / adverse effects*
  • Treatment Outcome
  • Vomiting / chemically induced
  • Vomiting / prevention & control

Substances

  • Antineoplastic Agents
  • Taxoids
  • Docetaxel