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Persons who have breast cancer that recurs (comes back) after initial treatment or has spread to other parts of the body need additional therapy to relieve the symptoms of disease and prolong survival time. Researchers from Italy recently reported that the chemotherapy combination of vinorelbine and paclitaxel may be 1 of the most effective options for women who have metastatic breast cancer that recurs after previous chemotherapy.

Treatment options for

cancer of the breast are dependent on many factors, including the

stage of disease (extent of disease at diagnosis), but may include surgery, chemotherapy combinations, radiation therapy, hormone therapy, and/or biologic therapy (to help the immune system fight the cancer). Often, surgery may be followed by additional treatment (called

adjuvant therapy) with a chemotherapy combination of cyclophosphamide, methotrexate, or fluorouracil with an anthracycline drug (doxorubicin or epirubicin). Unfortunately, even after such treatment some women will suffer a

recurrence (return) of the cancer. In the case of

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metastatic breast cancer, the cancer has spread from the breast to other parts of the body. When women have metastatic disease that recurs after initial chemotherapy, additional treatments are needed to relieve symptoms, enhance quality of life, and prolong survival time. Chemotherapy drugs that have shown anticancer activity in women with this type of disease are vinorelbine and the taxanes, paclitaxel and docetaxel. Recently, Italian researchers studied a combination of vinorelbine and paclitaxel in women with recurrent metastatic breast cancer.

Researchers treated 50 women who had metastatic disease that recurred after previous chemotherapy that included an anthracycline drug. The women received various doses of chemotherapy with paclitaxel and vinorelbine to determine the most effective and safest drug doses and schedules. For these patients, the complete response rate was 14% and the partial response rate was 48%. Twenty-seven persons received 1 of the doses that was ultimately deemed acceptable and effective (90mg/m

2 paclitaxel and 15mg/m

2 vinorelbine), and this dosage was used in a subsequent (phase II) study. In these 27 women, the complete response rate was 11% and the partial response rate was 52%. The average time it took for the disease to begin progressing again was 26 weeks, and the average survival time was 51 weeks. The most serious side effect of the treatment was low blood counts.

From these findings, the researchers concluded that the study dosage of vinorelbine and paclitaxel established here may be 1 of the most effective therapeutic options available for women with recurrent metastatic breast cancer who have previously undergone chemotherapy with an anthracycline drug. This vinorelbine/paclitaxel regimen showed good anticancer activity, required only half the drug doses that are needed when used as single agents, and caused no major side effects except for low blood counts. Persons who have this type of disease may wish to talk with their doctor about the risks and benefits of participating in a clinical trial in which vinorelbine/paclitaxel or another promising new therapy is being studied. Two sources of information on ongoing clinical trials include clinical trials listing services provided by the National Cancer Institute ( and also performs personalized clinical trial searches on behalf of patients. (

Cancer, Vol 88, No 12, pp 2731-2738, 2000)

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