CURRENT STATUS OF TAXOTERE(R) (DOCETAXEL) AS A NEW TREATMENT IN BREAST-CANCER

Therapy for advanced breast cancer has not improved significantly in r ecent years, remaining strictly palliative in nature and intent. One a pproach to increase the effectiveness of the treatment is the introduc tion of active new drugs. Taxotere(R) (docetaxel) is a taxoid derivati ve isolated from the needles of the European yew, Taxus baccata. Taxot ere promotes the assembly of microtubules and inhibits their depolymer ization. One EORTC Clinical Screening Group (CSG) phase II trial using Taxotere at 100 mg/m(2), 1 hour infusion without routine premedicatio n for hypersensitivity reactions, in first line chemotherapy, indicate s a high anti-tumor activity: 5 complete and 18 partial responses in 3 2 patients assessable for response (overall response rate 72%, 95% CI 53%-86%). Other studies confirm this activity in first line and second line chemotherapy for advanced disease and in patients who are refrac tory to anthracycline containing regimens. Grades III and IV neutropen ia without major infection, and grades I and II skin toxicity, were fr equently observed adverse events. A fluid retention syndrome (chronic cumulative and non life-threatening toxicity) has been noted in patien ts treated with Taxotere. Methods for controlling fluid retention - do se reduction to 75 mg/m(2) (which has little effect) or routine premed ication from the start of treatment - are currently being studied.