Breast cancer patients who take the Sanofi-Aventis drug docetaxel instead of the older medicine flurouracil cut their risk of death by 30%, researchers said on Wednesday. Among the women who received docetaxel, "there's no group of patients that didn't benefit, so you can't pick out someone who's not a winner from the new treatment," said study author John Mackey of the Cross Cancer Institute in Edmonton, Canada.
The benefit of the docetaxel combination "was so large and so striking it's turned a lot of heads. It's a high-water mark for chemotherapy. It has catapulted the (docetaxel) regimen into being a standard of care," Mackey said.
The study, published in the New England Journal of Medicine, involved 1,491 women in 20 countries whose tumors had spread to at least one lymph node. Each drug was used in combination with two other commonly used anticancer medicines, doxorubicin and cyclophosphamide.
The docetaxel treatment, which is already the standard of care in many cancer centers, reduced the risk of death after five years by 30%, bringing the survival rate up to 87%, compared to 81% for patients using flurouracil. Docetaxel also reduced the recurrence of cancer. Of the patients put on docetaxel, 25% had their breast tumors reappear after five years, compared to 32% of those using flurouracil.
Researchers, however, found that the docetaxel combination increased the risk of some serious side effects such as diarrhea and mouth sores. On the other hand, docetaxel produced significantly less nausea and vomiting than flurouracil. Another advantage of the docetaxel therapy was that it produced better results no matter how far the breast cancer cells had spread through nearby lymph nodes.
The flurouracil treatment "was a reasonable choice during the treatment period of 1995 to 1998, but this may not be the case in 2005," said Edith Perez of the Mayo Clinic in Jacksonville, Florida. But in her editorial in the New England Journal of Medicine, Perez said the side effects and the fact that the treatment was not tested on women older than 70 "cannot be minimized."
Docetaxel was approved for use in 1996 and is sold under the brand name Taxotere. Docetaxel is a chemical cousin of the drug Taxol, which has been around for more than a decade but still remains popular. Which one is better won't be known until the two are tested against each other. (Reuters)