Treatment patterns of docetaxel and paclitaxel in patients with early-stage breast cancer in a community oncology center

Abstract

e17550 Background: Docetaxel and paclitaxel have been widely used in treating breast cancer (BC). This study aimed to describe real-world treatment patterns of two taxanes in early-stage BC. Methods: Georgia Oncology Specialist Database (GOSD) was used and contained chemotherapy, medical and pharmacy claims, and lab results for nearly 170,000 patients with various types of cancer (2003–2008). Patients with stage I-III BC receiving doxirubicin-cyclophosphamide-taxane (ACT) were identified, and their pre-taxane and on-taxane periods (from first to last dose of docetaxel/paclitaxel) were examined. Number of cycles was compared using Student's t-test. Taxane dose schedule and the use of other chemotherapy in pre- and on-taxane periods were compared using Chi-Square test. A similar analysis was replicated using Pharmetrics database (2003–2008) in BC patients on ACT regimen with prior mastectomy. Results: In GOSD, 79 docetaxel (7.9%, 58.2%, 34.2% in stage I, II, III, respectively) and 139 paclitaxel (10.8%, 64.7%, 25.5% in stage I, II, III, respectively) patients were identified. Compared with paclitaxel, docetaxel patients completed more cycles (4.9 vs. 3.9, p < 0.001), were less frequently on weekly schedule, and more frequently on every-two-week (Q2w) or every-three-week (Q3W) schedules (2.5% vs. 15.2%, 27.9% vs. 62.6%, and 41.8% vs. 0%; p < 0.001). 22.8% of docetaxel patients received AC followed by docetaxel (AC>T) and 77.22% received ACT concurrently, while 100% of paclitaxel patients were on AC>T regimen. In Pharmetrics data, compared with paclitaxel (n = 211), docetaxel patients (n = 96) completed more cycles (11.3 vs. 4.6, p < 0.001), were less frequently on weekly, while more frequently on Q2W and Q3W schedules (3.1 vs. 9.5%, 9.4% vs. 62.6%, and 59.4% vs. 4.7%; p < 0.001). While 97.6% of paclitaxel patients were on AC>T regimen, AC>T and ACT regimens were evenly split among docetaxel patients (49% vs. 51%). Conclusions: Docetaxel and paclitaxel have different treatment patterns in real-world clinical practice. The patterns in a community oncology center appear to be consistent with national data. A potential limitation of this study is that the potential selection bias may not be fully adjusted. [Table: see text]