FIRST-LINE TREATMENT OF METASTATIC BREAST-CANCER

Although metastatic breast cancer is an incurable disease, chemotherap y has had an impact on survival since the use of anthracycline drugs h as become widespread. The optimal time for chemotherapeutic interventi on for disseminated disease is in the first-line setting, but optimal treatments vary amongst patients, and the treatment must be chosen aft er consideration of the characteristics of the patient and the disease . Amongst the new drugs which have been used in the treatment of metas tatic breast cancer, vinorelbine and the taxoids, docetaxel (Taxotere( R)) and paclitaxel (Taxol(R)), challenge monotherapy with anthracyclin e drugs, and even combination therapies, with regard to the response r ate obtainable. In five multicentre phase II trials, the response rate to docetaxel, 75 or 100 mg/m(2), given intravenously over 1 hour ever y 3 weeks, varied from 38 to 68%, with a median survival of 16.4 month s across all studies. Good performance status and treatment with the h igher dose improved response rates, though these effects were not stat istically significant. Docetaxel has proved to be a highly active mono therapy for metastatic breast cancer in the first-line setting.