Herceg Davorin, Vrbanec Damir
Zavod za internisticku onkologiju, Klinika za onkologiju, Klinicki bolnicki centar Zagreb.
Lijec Vjesn. 2009 May-Jun;131(5-6):133-41.
Taxanes were established as leading drugs in chemotherapy of breast cancer. In the first line chemotherapy of advanced disease taxanes were combined with other cytostatics. Taxane-based combinations in comparison with taxanes in sequential use were observed. There was insufficient evidence to discriminate in favour of taxane-based combinations. In randomized studies several oftaxane-based combinations were tested: taxanes with anthracyclines, capecitabine and gemcitabine. There is no evidence data to prefer any taxane combination to another. Taxanes became fundamental in the adjuvant setting of node positive breast cancer patients. The results of recent meta-analysis were not influenced by the number of axillary metastases or by estrogen receptor expression. At this time there is no data to support the superiority of any particular taxane. Paclitaxel is treatment schedule dependent, because its weekly administration setting may result in better treatment outcome. Docetaxel may be more effective if given every 3 weeks rather than weekly. Targeted therapy in combination with taxanes improves survival rate in adjuvant setting as in advanced disease.
紫杉烷类药物已成为乳腺癌化疗的主要药物。在晚期疾病的一线化疗中，紫杉烷类药物与其他细胞毒性药物联合使用。观察了基于紫杉烷的联合用药与序贯使用紫杉烷的情况。没有足够的证据支持倾向于基于紫杉烷的联合用药。在随机研究中，测试了几种基于紫杉烷的联合用药：紫杉烷与蒽环类药物、卡培他滨和吉西他滨联合。没有证据表明哪种紫杉烷联合用药优于其他联合用药。紫杉烷类药物在淋巴结阳性乳腺癌患者的辅助治疗中变得至关重要。近期荟萃分析的结果不受腋窝转移数量或雌激素受体表达的影响。目前没有数据支持任何一种特定紫杉烷的优越性。紫杉醇的治疗方案具有依赖性，因为其每周给药方案可能会带来更好的治疗效果。多西他赛每3周给药一次可能比每周给药更有效。在辅助治疗和晚期疾病中，靶向治疗与紫杉烷类药物联合使用可提高生存率。
