The use of low-dose Taxotere (docetaxel) on a weekly basis plus Xeloda (capecitabine) on a daily basis provided benefit for a significant portion of patients with breast cancer that has stopped responding to anthracyclines. The addition of Celebrex (celecoxib), however, did not provide any additional benefit. These results were recently presented at the 2008 annual American Society of Clinical Oncology (ASCO) breast cancer symposium.
Anthracyclines are an important class of chemotherapy agents for the treatment of breast cancer. Anthracyclines include Adriamycin (doxorubicin), Ellence (epirubicin), and Doxil (pegylated liposomal doxorubicin). Because there is no agreement on the optimal treatment of breast cancer that is resistant to anthracyclines, research continues to evaluate different treatment regimens among this group of patients.
Recently, metronic dosing, which is administration of small doses of drugs in a rapid cycle, has demonstrated a potential improvement in outcomes over standard dosing.
Researchers from Canada recently conducted a clinical trial including 47 patients with HER2-negative advanced breast cancer that had stopped responding to anthracyclines. Patients were treated with weekly Taxotere, daily Xeloda, and daily Celebrex. The primary objective of the trial was to achieve a clinical response, which was defined as a partial or complete regression of cancer or stabilization of cancer for at least six months.
- 42% of patients achieved a clinical benefit: 34% had a partial regression of cancer and 8% had stable disease.
- The median time to progression was 15 weeks; however this was increased to 32 weeks for patients who achieved a clinical benefit.
- The most common side effects were low levels of blood cells and diarrhea.
The researchers stated: This particular dosing schedule for [Taxotere] and oral [Xeloda] should be examined further in clinical studies involving combination therapy with novel targeted therapies.
Patients with breast cancer that has stopped responding to prior therapies may wish to speak with their physician regarding their individual risks and benefits of participation in a clinical trial further evaluating this treatment option or other novel therapeutic approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.eCancerTrials.com.
Reference: Young S, et al. Phase II clinical rial examining the activity of docetaxel and oral capecitabine given in metronomic fashion and concurrently with celecoxib in patients with anthracycline-resistant metastatic breast cancer. Proceedings from ASCO Breast. 2008; Abstract 256.