This Article Full Text Full Text (PDF) eLetters: Submit a response to this article Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article link to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints/Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by O’Shaughnessy, J. Articles by Aapro, M. Search for Related Content PubMed PubMed Citation Articles by O’Shaughnessy, J. Articles by Aapro, M.

Treatment for Anthracycline-Pretreated Metastatic Breast Cancer

^a Baylor-Sammons Cancer Center and US Oncology, Dallas, Texas, USA; ^b Cancer Research UK, Department of Medical Oncology, University of Glasgow and Beatson Oncology Centre, Glasgow, UK; ^c Institut Multidisciplinaire d’Oncologie, Clinique de Genolier, Genolier, Switzerland

Correspondence: Joyce O’Shaughnessy, M.D., US Oncology, 3535 Worth Street, Collins 5, Dallas, Texas 75246, USA. Telephone: 214-370-1795; Fax: 214-370-1850; e-mail: joyce.o\|[rsquo ]\|shaughnessy{at}usoncology.com

As a result of increasing anthracycline use earlier in the course of breast cancer, oncologists are frequently faced with the challenge of treating patients whose disease has progressed during or following anthracycline therapy or who are ineligible for further anthracycline therapy. Many of these women remain candidates for cytotoxic chemotherapy, and several treatment options exist. Until recently, the taxanes, docetaxel in particular, were widely regarded as the most effective therapy for these patients, based on a survival advantage observed with docetaxel. However, a recent phase III study demonstrated that the addition of capecitabine to docetaxel results in superior overall survival (with a 3-month improvement in median survival), superior time to disease progression, and a superior response rate, with a manageable safety profile. Capecitabine/docetaxel is the first cytotoxic combination to improve survival over standard monotherapy in patients with anthracycline-pretreated metastatic breast cancer. Moreover, the survival benefit can be attributed to the addition of capecitabine, as it was achieved despite the lower dose of docetaxel administered in the combination arm. Quality of life was maintained with capecitabine/docetaxel combination therapy, which further supports the use of this regimen in patients with anthracycline-pretreated metastatic breast cancer. Pharmacoeconomic modeling using the data from the phase III trial has shown that the capecitabine/docetaxel combination therapy is highly cost effective when compared with other cancer treatments that improve survival. This review describes several treatment options for patients with anthracycline-pretreated breast cancer, including the phase III data (efficacy, tolerability, quality of life, and pharmacoeconomics) for capecitabine plus docetaxel in this setting.

Key Words. Anthracyclines • Taxanes • Breast cancer • Capecitabine • Docetaxel • Pharmacoeconomics • Quality of life

This article has been cited by other articles:

				E. D. Saad, A. Katz, P. M. Hoff, and M. Buyse Progression-free survival as surrogate and as true end point: insights from the breast and colorectal cancer literature Ann. Onc., January 1, 2010; 21(1): 7 - 12. [Abstract] [Full Text] [PDF]

				E. M. Ciruelos, J. Cortes, H. Cortes-Funes, J. I. Mayordomo, B. Bermejo, B. Ojeda, E. Garcia, C. A. Rodriguez, M. Munoz, P. Gomez, et al. Gemcitabine and capecitabine in previously anthracycline-treated metastatic breast cancer: a multicenter phase II study (SOLTI 0301 trial) Ann. Onc., November 25, 2009; (2009) mdp536v1. [Abstract] [Full Text] [PDF]

				P. J. Barrett-Lee, J. M. Dixon, C. Farrell, A. Jones, R. Leonard, N. Murray, C. Palmieri, C. J. Plummer, A. Stanley, and M. W. Verrill Expert opinion on the use of anthracyclines in patients with advanced breast cancer at cardiac risk Ann. Onc., May 1, 2009; 20(5): 816 - 827. [Abstract] [Full Text] [PDF]

				E. D. Saad and A. Katz Progression-free survival and time to progression as primary end points in advanced breast cancer: often used, sometimes loosely defined Ann. Onc., March 1, 2009; 20(3): 460 - 464. [Abstract] [Full Text] [PDF]

				Y. Hiraumi, E. Iwai-Kanai, S. Baba, Y. Yui, Y. Kamitsuji, Y. Mizushima, H. Matsubara, M. Watanabe, K.-i. Watanabe, S. Toyokuni, et al. Granulocyte colony-stimulating factor protects cardiac mitochondria in the early phase of cardiac injury Am J Physiol Heart Circ Physiol, March 1, 2009; 296(3): H823 - H832. [Abstract] [Full Text] [PDF]

				J. Tfelt-Hansen, P. Schwarz, E. F. Terwilliger, E. M. Brown, and N. Chattopadhyay Calcium-Sensing Receptor Induces Messenger Ribonucleic Acid of Human Securin, Pituitary Tumor Transforming Gene, in Rat Testicular Cancer Endocrinology, December 1, 2003; 144(12): 5188 - 5193. [Abstract] [Full Text] [PDF]