Taxane-containing chemotherapy in the treatment of early breast cancer patients

In primary breast cancer, taxane-based compared with anthracycline-based adjuvant chemotherapy significantly reduces the relative risk of recurrence (ranging from 17% to 36%) and sometimes improves overall survival. Different dosages and schedules of anthracyclines and taxanes have been tested. Randomized studies comparing sequential versus concurrent administrations are in progress and no data about efficacy are available. However, based on a single randomized trial and on indirect comparisons, safety and tolerability seem to be better with sequential schema. A formal comparison between weekly and every 3 weeks administration of taxanes reported no substantial difference in terms of efficacy. However, taking into account a subgroup analysis of this study, and results coming from metastatic disease, the best way to give taxanes seems to be either weekly paclitaxel or docetaxel every 3 weeks. In the majority of the study, taxane efficacy seems to be independent of hormonal receptor status, i.e. active in both hormonal receptor positive and negative disease. In conclusion, taxane-based adjuvant chemotherapy is a standard option for most early breast cancer patients with node-positive disease. No sufficient and dedicated data are available in node-negative disease.