A literature-based meta-analysis taxane-based doublet versus single-agent taxane chemotherapy in patients with advanced breast cancer
- 185 Downloads
Clinical trials have reported conflicting results as to whether taxane-based doublet improves outcome over single-agent taxane in patients with advanced breast cancer.
We performed a meta-analysis comparing primary and secondary end points of taxane-based doublet with single-agent taxane chemotherapy in patients with advanced breast cancer and prior anthracycline treatment. The event-based relative risk ratio (RR) with 95% confidence intervals (95% CI) was derived, and a test of heterogeneity was applied.
Four eligible trials (2,343 patients) were selected from 488 studies that initially were identified. A significant difference in favoring taxane-based doublet over single-agent taxane was observed in progression-free survival (PFS) (RR, 1.33; 95% CI, 1.02–1.75; P = 0.039) and partial response (PR) (RR, 1.43; 95% CI, 1.10–1.86; P = 0.008). The ORR was higher for patients receiving taxane-based doublet, although not statistically significant (RR, 1.17; 95% CI, 0.91–1.50; P = 0.220). Whereas there was no difference in 1-year survival rate (1-year SR) (RR, 1.05; 95% CI, 0.94–1.17; P = 0.422), clinical benefit (CB) (RR, 1.02; 95% CI, 0.95–1.09; P = 0.642), and complete response (CR) (RR, 0.75; 95% CI, 0.31–1.79; P = 0.512). Toxicities did not differ significantly except stomatitis and diarrhea.
Taxane-based doublet appeared to improve PFS and PR compared with single-agent taxane in the treatment of patients with advanced breast cancer. Further prospective, randomized, controlled trials will be necessary.
KeywordsMeta-analysis Taxane Breast cancer Doublet regimen Advanced
Conflict of interest
We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work; there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled, “A literature-based meta-analysis of taxane-based doublet versus single-agent taxane chemotherapy in patients with advanced breast cancer”.
- Albain KS, Nag SM, Calderillo-Ruiz G, Jordaan JP, Llombart AC, Janusz Rolski AP, Melemed AS, Reyes-Vidal JM, Sekhon JS, Simms L, O’Shaughnessy J (2008) Gemcitabine plus Paclitaxel versus Paclitaxel monotherapy in patients with metastatic breast cancer and prior anthracycline treatment. J Clin Oncol 26:3950–3957PubMedCrossRefGoogle Scholar
- Bontenbal M, Creemers GJ, Braun HJ, de Boer AC, Janssen JT, Leys RB, Ruit JB, Goey SH, van der Velden PC, Kerkhofs LG, Schothorst KL, Schmitz PI, Bokma HJ, Verweij J, Seynaeve C (2005) Phase II to III study comparing doxorubicin and docetaxel with fluorouracil, doxorubicin, and cyclophosphamide as first-line chemotherapy in patients with metastatic breast cancer: results of a dutch community setting trial for the Clinical Trial Group of the Comprehensive Cancer Centre. J Clin Oncol 23:7081–7088PubMedCrossRefGoogle Scholar
- Chan S, Friedrichs K, Noel D, Pintér T, Van Belle S, Vorobiof D, Duarte R, Gil Gil M, Bodrogi I, Murray E, Yelle L, von Minckwitz G, Korec S, Simmonds P, Buzzi F, González Mancha R, Richardson G, Walpole E, Ronzoni M, Murawsky M, Alakl M, Riva A, Crown J (1999) Prospective randomized trial of docetaxel versus doxorubicin in patients with metastatic breast cancer. J Clin Oncol 17:2341–2354PubMedGoogle Scholar
- Di Leo A, Gomez HL, Aziz Z, Zvirbule Z, Bines J, Arbushites MC, Guerrera SF, Koehler M, Oliva C, Stein SH, Williams LS, Dering J, Finn RS, Press MF (2008) Phase III, double-blind, randomized study comparing lapatinib plus paclitaxel with placebo plus paclitaxel as first-line treatment for metastatic breast cancer. J Clin Oncol 26:5544–5552PubMedCrossRefGoogle Scholar
- Fountzilas G, Dafni U, Dimopoulos MA, Koutras A, Skarlos D, Papakostas P, Gogas H, Bafaloukos D, Kalogera-Fountzila A, Samantas E, Briasoulis E, Pectasides D, Maniadakis N, Matsiakou F, Aravantinos G, Papadimitriou C, Karina M, Christodoulou C, Kosmidis P, Kalofonos HP (2009) A randomized phase III study comparing three anthracycline-free taxane-based regimens, as first line chemotherapy, in metastatic breast cancer: a Hellenic Cooperative Oncology Group study. Breast Cancer Res Treat 115:87–99PubMedCrossRefGoogle Scholar
- Hainsworth JD, Burris HA, Yardley DA, Bradof JE, Grimaldi M, Kalman LA, Sullivan T, Baker M, Erland JB, Greco FA (2001) Weekly docetaxel in the treatment of elderly patients with advanced breast cancer: a Minnie Pearl Cancer Research Network phase II trial. J Clin Oncol 19:3500–3505PubMedGoogle Scholar
- Horiguchi J, Oyama T, Koibuchi Y, Yokoe T, Takata D, Ikeda F, Nagaoka H, Rokutanda N, Nagaoka R, Ishikawa Y, Odawara H, Kikuchi M, Sato A, Iino Y, Takeyoshi I (2009) Neoadjuvant weekly paclitaxel with and without trastuzumab in locally advanced or metastatic breast cancer. Anticancer Res 29:517–524PubMedGoogle Scholar
- Icli E, Akbulut h, Uner A (2002) Paclitaxel (T) vs cisplatin + VP-16 (EP) in metastatic breast cancer patients treated with anthracyclines: a phase III randomized study. Turkish Oncology Group. Ann Oncol 13(Suppl 5):47Google Scholar
- Icli F, Akbulut H, Uner A, Yalcin B, Baltali E, Altinbas M, Coşkun S, Komurcu S, Erkisi M, Demirkazik A, Senler FC, Sencan O, Büyükcelik A, Boruban C, Onur H, Zengin N, Sak SD (2005) Cisplatin plus oral etoposide (EoP) combination is more effective than paclitaxel in patients with advanced breast cancer pretreated with anthracyclines: a randomised phase III trial of Turkish Oncology Group. Br J Cancer 92:639–644PubMedCrossRefGoogle Scholar
- Jackisch C, Eibach H, Knuth A (2000) Phase II trial of docetaxel weekly as dose dense treatment in metastatic breast cancer (MBC). Proc Am Soc Clin Oncol 18:417aGoogle Scholar
- Nabholtz JM, Thuerlimann B, Bezwoda WR, Melnychuk D, Dounma J, Vandenberg TA, Rapoport B, Rosso R, Trillet Lenoir V, Drbal J, Aapro MA, Alaki M, Murawsky M, Allesandro R (1997) Docetaxel vs mitomycin plus vinblastine in anthracycline-resistant metastatic breast cancer. Oncology (Williston Park) 11(Suppl 8):25–30Google Scholar
- Nabholtz JM, Senn HJ, Bezwoda W, Melnychuk D, Deschênes L, Douma J, Vandenberg TA, Rapoport B, Rosso R, Trillet-Lenoir V, Drbal J, Molino A, Nortier JW, Richel DJ, Nagykalnai T, Siedlecki P, Wilking N, Genot JY, Hupperets PS, Pannuti F, Skarlos D, Tomiak EM, Murawsky M, Alakl M, Aapro M (1999) Prospective randomized trial of docetaxel versus mitomycin plus vinblastine in patients with metastatic breast cancer progressing despite previous anthracycline-containing chemotherapy. 304 Study Group. J Clin Oncol 17:1413–1424PubMedGoogle Scholar
- O’Shaughnessy J, Miles D, Vukelja S, Moiseyenko V, Ayoub JP, Cervantes G, Fumoleau P, Jones S, Lui WY, Mauriac L, Twelves C, Hazel GV, Verma S, Leonard R (2002) Superior survival with capecitabine plus docetaxel combination therapy in anthracycline-pretreated patients with advanced breast cancer: phase III trial results. J Clin Oncol 20:2812–2823PubMedCrossRefGoogle Scholar
- Ramos M, Gonzalez-Ageitos A, Amenedo M, Gonzalez-quintas A, Gamzo JL, Togores P, Losada G, Almanza C, Romero C, Gomez-martin C (2003) Weekly docetaxel as second-line therapy for patients with advanced breast cancer resistant to previous anthracycline treatment. J Chemother 15:192–197PubMedGoogle Scholar
- Sjostrom J, Blomqvist C, Mouridsen H, Pluzanska A, Ottosson Lonn S, Bengtsson NO, Ostenstad B, Mjaaland I, Palm Sjovall M, Wist E, Valvere V, Anderson H, Bergh J (1999) Docetaxel compared with sequential methotrexate and 5-fluorouracil in patients with advanced breast cancer after anthracycline failure: a randomised phase III study with crossover on progression by the Scandinavian Breast Group. Eur J Cancer 35:1194–1201PubMedCrossRefGoogle Scholar
- Sparano JA, Makhson AN, Semiglazov VF, Tjulandin SA, Balashova OI, Bondarenko IN, Bogdanova NV, Manikhas GM, Oliynychenko GP, Chatikhine VA, Zhuang SH, Xiu L, Yuan ZL, Rackoff WR (2009) Pegylated liposomal doxorubicin plus docetaxel significantly improves time to progression without additive cardiotoxicity compared with docetaxel monotherapy in patients with advanced breast cancer previously treated with neoadjuvant-adjuvant anthracycline therapy: results from a randomized phase III study. J Clin Oncol 27:4522–4529PubMedCrossRefGoogle Scholar
- Von Hoff DD, Layard MW, Basa P, Davis HL Jr, Von Hoff AL, Rozencweig M, Muggia FM (1979) Risk factors for doxorubicin-induced congestive heart failure. Ann Intern Med 91:710–717Google Scholar