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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/8257

Title: Taxanes alone or in combination with anthracyclines as first-line therapy of patients with metastatic breast cancer
Authors: Piccart-Gebhart, Martine J.
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
Citation: 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
URI: http://hdl.handle.net/1942/8257
ISI #: 000255054700014
ISSN: 0732-183X
Category: A1
Type: Journal Contribution
Validation: ecoom, 2009
Appears in Collections: Research publications

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