Docetaxel, doxorubicin and cyclophosphamide [TAC] as first line-chemotherapy for metastatic breast cancer

ABSTRACT

This study was designed to investigate the efficacy and toxicity of docetaxel with doxorubicin and cyclophosphamide [TAC] as first-line chemotherapy for metastatic breast cancer. Forty-four patients received 3-week cycles of docetaxel 75 mg/m[2] 1 hour I. V. infusion, preceded by I. V. doxorubicin 50 mg/m[2] and cyclophosphamide 500 mg/m[2] for a maximum of 6 cycles. Complete response was achieved in 4 patients [9%]. The overall objective response rate was 70%. The objective response rates in patients with bone, lymph nodes, liver and lung involvement was 81%, 73%, 71% and 67% respectively. The median duration of response was 12 months and the median time to progression was nine months. With a median follow-up of 18 months, the median survival was 18 months whereas the 1 and 2-year survival rates were 64% and 38% respectively. The main toxicities were hematological [neutropenia in 82% of patients, anemia in 46% and thrombocytopenia in 25% of patients]. Non-hematological adverse events were infrequent and docetaxel-specific toxicities [such as fluid retention and nail changes] were mild. No anaphylaxis, cardiac toxicity or febrile neutropenia were observed in any patient. The docetaxel-doxorubicin-based TAC combination seems to be active as first-line treatment of patients with metastatic breast cancer. Although neutropenia was frequent, it was manageable. The rest of the toxicity profile seems acceptable, with no significant nonhematologic toxicities. Further randomized trials are needed to establish the role of docetaxel in the treatment strategies and natural history of breast cancer