Taxoïdbevattende adjuvante chemotherapie bij het mammacarcinoom: binnenkort te verwachten

- Taxanes such as paclitaxel and docetaxel are effective cytostatic agents in metastatic breast cancer. Until now, six randomised studies with taxanes as a component of adjuvant chemotherapy for non-metastasised mammary carcinoma have been reported: four with paclitaxel and two with docetaxel. The results were more favourable in the patients treated with paclitaxel than in the controls: the absolute difference in 5-year disease-free survival was 4-5 (to be added to the 65-72 following the standard treatment) and that in total 5-year survival was 0-3 (to be added to the 77-85 following the standard treatment). The benefits of the administration of paclitaxel were not accompanied by serious myelotoxicity. Treatment with docetaxel also resulted in more patients with disease-free 5-year survival (68 vs. 75) and total 5-year survival (81 vs. 87). The advantage of the combination with docetaxel was most pronounced in patients with 1-3 positive nodes and those with HER 2 overexpression in their tumour. Febrile neutropenia was more common in de docetaxel group but there was no increased mortality due to toxicity. In the near future, it is expected that taxanes will play an important role in the adjuvant chemotherapy of breast cancer.