Fewer Side Effects With Weekly Paclitaxel in Breast Cancer
(HealthDay News) – For women with breast cancer, low-dose weekly paclitaxel is as effective as the standard-dose regimen given every two weeks, with fewer side effects; and axillary radiotherapy (ART) may be better than axillary lymph node dissection (ALND) in the case of positive sentinel lymph node biopsy, according to two studies presented at the annual meeting of the American Society of Clinical Oncology, held from May 31–June 4 in Chicago.
G. Thomas Budd, MD, from the Cleveland Clinic, and colleagues randomized patients with node-positive or high-risk node-negative operable breast cancer, who had received chemotherapy, to standard-dose paclitaxel given every two weeks or low-dose weekly paclitaxel, each for 12 weeks. The researchers found that five-year progression-free survival rates were similar for the two regimens (82% and 81%, respectively). Adverse events, including allergic reactions, muscle and bone pain, and neurologic toxicity, were more frequent with the every-two-weeks vs. the weekly schedule.
Emiel J. Rutgers, MD, from the Netherlands Cancer Institute in Amsterdam, and colleagues randomized women with early-stage, invasive breast tumors with positive sentinel lymph node biopsy to ALND (744 women) or ART (681 women), and followed them for a median of 6.1 years. The researchers observed no significant differences in five-year overall survival (92.5–93.3%) or disease-free survival rates (82.6–86.9%) between the groups. Significantly more patients in the ALND group had lymphedema than in the ART group (40% vs. 22% in first year; 28% vs. 14% at five years).
"I am sure these findings will lead to many doctors rethinking their strategy for treating patients who have a positive sentinel lymph node biopsy," Rutgers said in a statement.
The Budd study was funded in part by Amgen.