Limits...
Effects on quality of life, anti-cancer responses, breast conserving surgery and survival with neoadjuvant docetaxel: a randomised study of sequential weekly versus three-weekly docetaxel following neoadjuvant doxorubicin and cyclophosphamide in women with primary breast cancer.

Walker LG, Eremin JM, Aloysius MM, Vassanasiri W, Walker MB, El-Sheemy M, Cowley G, Beer J, Samphao S, Wiseman J, Jibril JA, Valerio D, Clarke DJ, Kamal M, Thorpe GW, Baria K, Eremin O - BMC Cancer (2011)

Bottom Line: However, no studies have compared the standard three weekly regimen to the weekly regimen in terms of quality of life.The primary aim of our study was to compare the effects on QoL of weekly versus 3-weekly sequential neoadjuvant docetaxel.ISRCTN: ISRCTN09184069.

View Article: PubMed Central - HTML - PubMed

Affiliation: Oncology Health Centres and the Institute of Rehabilitation, University of Hull, Kingston upon Hull, East Riding of Yorkshire HU3 2PG, UK.

ABSTRACT

Background: Weekly docetaxel has occasionally been used in the neoadjuvant to downstage breast cancer to reduce toxicity and possibly enhance quality of life. However, no studies have compared the standard three weekly regimen to the weekly regimen in terms of quality of life. The primary aim of our study was to compare the effects on QoL of weekly versus 3-weekly sequential neoadjuvant docetaxel. Secondary aims were to determine the clinical and pathological responses, incidence of Breast Conserving Surgery (BCS), Disease Free Survival (DFS) and Overall Survival (OS).

Methods: Eighty-nine patients receiving four cycles of doxorubicin and cyclophosphamide were randomised to receive twelve cycles of weekly docetaxel (33 mg/m2) or four cycles of 3-weekly docetaxel (100 mg/m2). The Functional Assessment of Cancer Therapy-Breast and psychosocial questionnaires were completed.

Results: At a median follow-up of 71.5 months, there was no difference in the Trial Outcome Index scores between treatment groups. During weekly docetaxel, patients experienced less constipation, nail problems, neuropathy, tiredness, distress, depressed mood, and unhappiness. There were no differences in overall clinical response (93% vs. 90%), pathological complete response (20% vs. 27%), and breast-conserving surgery (BCS) rates (49% vs. 42%). Disease-free survival and overall survival were similar between treatment groups.

Conclusions: Weekly docetaxel is well-tolerated and has less distressing side-effects, without compromising therapeutic responses, Breast Conserving Surgery (BCS) or survival outcomes in the neoadjuvant setting.

Trial registration: ISRCTN: ISRCTN09184069.

Show MeSH

Related in: MedlinePlus

Kaplan-Meier survival curves of (A) disease-free survival and (B) overall survival between age groups at study entry. HR, hazard ratio; CI, confidence interval; (--), women >50 years; (---), women ≤50 years
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3117815&req=5

Figure 3: Kaplan-Meier survival curves of (A) disease-free survival and (B) overall survival between age groups at study entry. HR, hazard ratio; CI, confidence interval; (--), women >50 years; (---), women ≤50 years

Mentions: Age at entry was a highly significant predictor of survival. Women >50 years had significantly better DFS (88% vs. 62%, p = 0.006) and OS (95% vs. 71%, p = 0.004), compared with those who were ≤ 50 years (Figure 3). These remained significant differences when adjusted for clinical tumour size, clinical and pathological nodal status, and tumour grade. The pCR and pathological nodal status were not predictors for survival in this study.


Effects on quality of life, anti-cancer responses, breast conserving surgery and survival with neoadjuvant docetaxel: a randomised study of sequential weekly versus three-weekly docetaxel following neoadjuvant doxorubicin and cyclophosphamide in women with primary breast cancer.

Walker LG, Eremin JM, Aloysius MM, Vassanasiri W, Walker MB, El-Sheemy M, Cowley G, Beer J, Samphao S, Wiseman J, Jibril JA, Valerio D, Clarke DJ, Kamal M, Thorpe GW, Baria K, Eremin O - BMC Cancer (2011)

Kaplan-Meier survival curves of (A) disease-free survival and (B) overall survival between age groups at study entry. HR, hazard ratio; CI, confidence interval; (--), women >50 years; (---), women ≤50 years
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3117815&req=5

Figure 3: Kaplan-Meier survival curves of (A) disease-free survival and (B) overall survival between age groups at study entry. HR, hazard ratio; CI, confidence interval; (--), women >50 years; (---), women ≤50 years
Mentions: Age at entry was a highly significant predictor of survival. Women >50 years had significantly better DFS (88% vs. 62%, p = 0.006) and OS (95% vs. 71%, p = 0.004), compared with those who were ≤ 50 years (Figure 3). These remained significant differences when adjusted for clinical tumour size, clinical and pathological nodal status, and tumour grade. The pCR and pathological nodal status were not predictors for survival in this study.

Bottom Line: However, no studies have compared the standard three weekly regimen to the weekly regimen in terms of quality of life.The primary aim of our study was to compare the effects on QoL of weekly versus 3-weekly sequential neoadjuvant docetaxel.ISRCTN: ISRCTN09184069.

View Article: PubMed Central - HTML - PubMed

Affiliation: Oncology Health Centres and the Institute of Rehabilitation, University of Hull, Kingston upon Hull, East Riding of Yorkshire HU3 2PG, UK.

ABSTRACT

Background: Weekly docetaxel has occasionally been used in the neoadjuvant to downstage breast cancer to reduce toxicity and possibly enhance quality of life. However, no studies have compared the standard three weekly regimen to the weekly regimen in terms of quality of life. The primary aim of our study was to compare the effects on QoL of weekly versus 3-weekly sequential neoadjuvant docetaxel. Secondary aims were to determine the clinical and pathological responses, incidence of Breast Conserving Surgery (BCS), Disease Free Survival (DFS) and Overall Survival (OS).

Methods: Eighty-nine patients receiving four cycles of doxorubicin and cyclophosphamide were randomised to receive twelve cycles of weekly docetaxel (33 mg/m2) or four cycles of 3-weekly docetaxel (100 mg/m2). The Functional Assessment of Cancer Therapy-Breast and psychosocial questionnaires were completed.

Results: At a median follow-up of 71.5 months, there was no difference in the Trial Outcome Index scores between treatment groups. During weekly docetaxel, patients experienced less constipation, nail problems, neuropathy, tiredness, distress, depressed mood, and unhappiness. There were no differences in overall clinical response (93% vs. 90%), pathological complete response (20% vs. 27%), and breast-conserving surgery (BCS) rates (49% vs. 42%). Disease-free survival and overall survival were similar between treatment groups.

Conclusions: Weekly docetaxel is well-tolerated and has less distressing side-effects, without compromising therapeutic responses, Breast Conserving Surgery (BCS) or survival outcomes in the neoadjuvant setting.

Trial registration: ISRCTN: ISRCTN09184069.

Show MeSH
Related in: MedlinePlus