Role of Taxanes

Abstract

Among the cytotoxic agents developed in the past decade for the treatment of advanced breast cancer, the taxanes are emerging as the most important. The question of optimal schedule and dose for paclitaxel is not definitively answered. For current clinical practice, the balance data favours doses of 175–200 mg/m2 over 3 h every 3 weeks. There has been no real controversy regarding docetaxel schedule and dose. Most frequently is used docetaxel at 100 mg/m2 given over 1 h every 3 weeks. Docetaxel or paclitaxel–anthracycline combinations represent a reasonable first-line option for patients with metastatic breast cancer. In particular in patients with rapidly progressive visceral metastases in whom improved response rates may be important to achieve effective short-term control of disease. For women with HER-2 positive metastatic breast cancer who are candidates for taxanes based chemotherapy merit consideration of concurrent trastuzumab therapy as first-line option. The future challenge is certainly represented by the identification of predictive factors that may guide clinicians, in the choice of the most appropriate chemotherapy regimen for each patient.