Breast Cancer Patients Benefit from Weekly Taxol Doses
Women who take the drug Taxol®weekly after receiving
chemotherapy for 12 weeks live longer compared to women who take four Taxol
treatments every three weeks, according to a report in the
New England Journal of Medicine.
In addition, the researchers say breast cancer patients
live longer without a recurrence of their breast cancer.
The study also evaluated another medication in the same
family, called Taxotere® (docetaxel), but found that weekly Taxol (paclitaxel)
was more effective.
"The findings suggest that weekly Taxol for 12 weeks is
more effective than four cycles of Taxol and should be considered a new
standard," says study author Dr. Joseph A. Sparano.
Prior to this study, four cycles of Taxol was considered
the standard, although many oncologists were administering the medications
weekly.
"We have been using Taxol weekly for at least a year," says
Dr. Kumud Tripathy, at Texas A & M Health Science Center College of Medicine in
Bryan, Texas.
Women with breast cancer who receive medications known as
taxanes after standard chemotherapy have a substantially reduced risk of
recurrence and of death. The other taxane, Taxotere (docetaxel) is more potent
than Taxol.
About a decade ago, a study showed that adding Taxol to
standard chemotherapy reduced the risk of breast cancer recurrence. The
medication was subsequently approved in the US, with the standard of care being
four doses once every three weeks.
A later study showed that giving the same dosage every two
weeks was more effective than every three weeks, so that became common practice.
In the meantime, questions were raised as to whether
taxanes were effective for the most common type of breast cancer, or that which
is hormone-receptor positive and HER2-negative.
"It raised a lot of concerns," says Dr. Sparano, at
Montefiore-Einstein Cancer Center in the Bronx, New York. "People were saying,
'Wait a minute. We thought Taxol was very effective, and maybe it's not as
effective as we thought, and are we treating people unnecessarily?'"
In the new study, Dr. Sparano and his colleagues compared
the effectiveness of giving standard chemo (doxorubicin and cyclophosphamide at
three-week intervals) plus four cycles or doses of Taxol every three weeks
versus every week for 12 doses at a lower dose.
They also compared Taxol with Taxotere (four cycles every
three weeks) or Taxotere given either every three weeks for four treatments or
weekly for 12 treatments.
The study involved almost 5,000 women.
There were no significant differences in survival between
those treated with Taxol and those treated with Taxotere or between the groups
treated weekly or every three weeks.
There was no indication that weekly Taxol was less
effective in women with hormone-receptor-positive, HER2-negative breast cancer.
"Taxol is effective in patients with one or more common
subtypes [of breast cancer] and, if it is going to be used in that population,
should be delivered weekly for 12 weeks rather than every three weeks for four
treatments," explains Dr. Sparano.
Always consult your physician for more information.
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Taxol, or paclitaxel, is a medication used for treating
certain women who have advanced breast or ovarian cancer. Paclitaxel is a
compound that is extracted from the bark of the Pacific yew tree.
In December of 1992, the US Food
and Drug Administration (FDA) approved Taxol for treatment of ovarian
cancer that had not responded to standard chemotherapy.
Subsequent clinical trials demonstrated that Taxol was
also effective in treating advanced breast cancer.
In April of 1994, the FDA
approved Taxol for the treatment of metastatic breast cancer that did not
respond to combination chemotherapy, or breast cancer that had recurred
within six months after the completion of initial chemotherapy.
Taxol has now been approved for adjuvant treatment of
breast cancer that has spread to the lymph nodes when given following a
doxorubicin chemotherapy regimen.
Taxol is given as an infusion drip into the vein.
Taxol is a taxane. Taxanes are a group of medications
used to treat breast cancer. Other taxanes include docetaxel (Taxotere) and
paclitaxel (Abraxane®).
Taxotere has been approved for treatment of locally
advanced or metastatic breast cancer.
Abraxane is approved for use in advanced or recurrent
breast cancer. Abraxane is a new formulation of paclitaxel that can be given
over thirty minutes as opposed to three hours for Taxol and there is less
likelihood of an adverse reaction to the drug.
Women considering taking Taxol should consult their
physician. Everyone experiences side effects differently. Side effects of
Taxol (and taxanes) may include:
- hair loss
- numbness of the fingers and toes
- neutropenia - a decrease in white blood cells which may increase the
risk of infections
- nausea and vomiting
- headaches
- mouth sores
- aching or pain in joints and muscles
- diarrhea
- skin rash
According to the National Cancer
Institute and the American Cancer Society,
the risks associated with Taxol are believed to be outweighed by the
benefits for persons with advanced breast cancer.
New studies continue to evaluate the effectiveness of
Taxol as well as the development of a new semi-synthetic paclitaxel.
Always consult your physician for more information.
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