Paclitaxel based chemotherpay increases survival in Metastatic Breast Cancer compared to standard treatment.

The following is an abstract of results presented at the 27th ESMO Congress.

New data adds to existing evidence that paclitaxel offers women with metastatic breast cancer (MBC) an improvement in overall survival compared to standard treatment, as well as a chance of improved progression-free survival, the largest improvements ever seen.

Data was collected from 640 patients treated in a consecutive series of studies between 1994 and 2001. It showed an improvement in tumour shrinkage when treated with paclitaxel based chemotherapy.

Analysis of the data showed that the 291 patients receiving epirubicin and paclitaxel as first-line treatments has a 31% reduction in the hazard of death (hazard ratio [HR], 0.69; p<0.003) and a 33% reduction in the hazard of disease progression (HR, 0.67; p<0.0001) on top of that seen with the 349 patients who receive 5-FU, epirubicin and cyclophosphamide (FEC), the standard combination currently used to treat women with MBC. The median survival of patients treated with epirubicin and paclitaxel was 24 months compared to 18 months with the FEC regimen, which meant that epirubicin and paclitaxel offered a six month gain on top of that seen with FEC. The 291 patients receiving the epirubicin and paclitaxel combination had an overall response rate (RR) to this therapy of 66% (and complete response of 16%). The remaining 349 patients who received FEC showed a 50% overall RR (complete response 15%). Therefore the difference in RRs was in favour of the epirubicin and paclitaxel regimen with a 16% higher response than that seen with FEC, yet the survival gain in this group of patients was much higher at 31%. The effect of epirubicin and paclitaxel on survival was not entirely accounted for by its effect on response which indicated that paclitaxel based therapy is an independent predictive factor of survival. The authors believe that the strength of this new data lies in the fact that all 6 studies in the analysis were originally conducted by the same investigators at St Chiara University Hospital, Pisa, Italy over an 18 year period that started in 1983 with recruitment of the first patients. The ensuring retrospective analysis therefore allowed for comparable inclusion criteria and the same study endpoints of RRs, progression-free survival and overall survival. (Source: Espicom Business Intelligence, 30th October, 2002)