Ravdin P M
Division of Oncology, University of Texas Health Science Center San Antonio, 78284-7884, USA.
Semin Oncol. 1999 Jun;26(3 Suppl 9):20-3.
The need for improved adjuvant chemotherapy programs for breast cancer patients is emphasized by the 1998 overview analysis of adjuvant trials, which demonstrates that although there has been substantial incremental advances in adjuvant therapy, relapse and death are prevented in less than half of women with micrometastatic disease. Because both docetaxel (Taxotere; Rhône-Pouleuc Rorer, Collegeville, PA) and paclitaxel have substantial non-cross-resistance with anthracyclines and therefore activity in anthracycline-resistant breast cancer, defining their roles in the adjuvant therapy of breast cancer is an area of great interest and active clinical investigation. The results of the adjuvant trials using docetaxel assume a particular importance because of the two taxanes in clinical use at this time, docetaxel may be the more active agent in the treatment of metastatic breast cancer, as demonstrated in the results from phase II and III randomized trials. Ongoing or soon-to-open adjuvant trials are evaluating the impact of docetaxel added to conventional adjuvant anthracyclines regimens, substituted for anthracyclines, used in combination with anthracyclines, and in direct comparison to paclitaxel. The results of these ongoing adjuvant trials will define the role of docetaxel in adjuvant chemotherapy programs for the management of patients with breast cancer and are eagerly awaited.
1998年辅助治疗试验的综述分析强调了改善乳腺癌患者辅助化疗方案的必要性，该分析表明，尽管辅助治疗取得了显著的渐进性进展，但在微转移疾病患者中，不到一半的人能够预防复发和死亡。由于多西他赛（泰索帝；罗纳普朗克·罗雷尔公司，宾夕法尼亚州学院镇）和紫杉醇与蒽环类药物具有显著的非交叉耐药性，因此在蒽环类耐药乳腺癌中具有活性，确定它们在乳腺癌辅助治疗中的作用是一个备受关注且正在积极进行临床研究的领域。使用多西他赛的辅助治疗试验结果具有特别重要的意义，因为在目前临床使用的两种紫杉烷中，多西他赛在转移性乳腺癌治疗中可能是更具活性的药物，这在II期和III期随机试验结果中得到了证实。正在进行或即将开展的辅助治疗试验正在评估将多西他赛添加到传统辅助蒽环类药物方案中、替代蒽环类药物、与蒽环类药物联合使用以及与紫杉醇直接比较的影响。这些正在进行的辅助治疗试验结果将确定多西他赛在乳腺癌患者管理的辅助化疗方案中的作用，人们急切期待着这些结果。
