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A new chemotherapy combination consisting of docetaxel, doxorubicin and cyclophosphamide has produced encouraging results, appearing to be effective at prolonging survival for patients with metastatic breast cancer, according to a recent article published in the

Journal of Clinical Oncology. New combinations of chemotherapy for advanced breast cancer are always being considered in order to improve upon survival time of patients with this disease.

Breast cancer is a common malignancy occurring in women in the United States with approximately 200,000 new cases diagnosed each year. Breast cancer is characterized by the presence of cancer cells in the tissues or ducts of the breast. Metastatic or advanced breast cancer refers to cancer that has spread outside the breast to distant locations in the body, often including vital organs. There is no defined standard treatment for patients with this disease; however, combination chemotherapy regimens including an anthracycline (doxorubicin or epirubicin) are typically used as initial treatment. Taxanes (docetaxel and paclitaxel) are also emerging as promising additions to chemotherapy combinations. Unfortunately, most women ultimately stop responding to treatment and experience a return of their cancer. Therefore, different chemotherapy combinations are continually being evaluated in an attempt to produce the greatest survival time coupled with improved quality of life for patients with this disease.

In a recent clinical trial, the combination of docetaxel, doxorubicin and cyclophosphamide (TAC) was evaluated as initial treatment for patients with metastatic breast cancer. Partial or complete disappearance of cancer following treatment with TAC was achieved in 77% of patients. Two years following treatment, nearly 60% of patients were still alive. The average survival had not yet been established at approximately 3 years following treatment. Low white blood counts were the most common side effect from treatment.

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These results are encouraging for patients with metastatic breast cancer, offering a novel effective chemotherapy combination that produces long-term survival benefit. The last phases of clinical trials will begin in which TAC is directly compared to other commonly used chemotherapy combinations. Results from these trials will help define the potential role of TAC in the clinical setting as treatment for metastatic breast cancer.

Patients with metastatic breast cancer may wish to speak with their physician about the risks and benefits of participating in a clinical trial evaluating TAC or other promising new treatments.

(Journal of Clinical Oncology, Vol 19, No 2, pp 314-321, 2001)

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