DOSE-DENSE PACLITAXEL-CONTAINING ADJUVANT THERAPY FOR BREAST-CANCER

The use of dose-dense therapy is one approach to overcoming the ''resi stance'' of malignant cells to adjuvant therapy caused by inadequate d rug exposure. In this approach, active drugs are delivered sequentiall y at their ''ideal'' dose level separated by short intertreatment inte rvals. Thus, dose intensification is achieved by means of rapidly recy cled treatments rather than by dramatic dose escalation. To overcome a bsolute cellular resistance, the addition of new, active, non-cross-re sistant drugs holds great promise and has specifically motivated the t esting of the taxanes. This article describes the results of clinical trials of dose-dense therapy, with particular emphasis on attempts to incorporate one taxane, paclitaxel (Taxol), into the dose-dense regime n of sequential doxorubicin and cyclophosphamide-the so-called A --> T --> C regimen, and into more conventional regimens.