Prospective randomized trial of docetaxel versus doxorubicin in patients with metastatic breast cancer

Stephen Chan, Kay Friedrichs, Daniel Noel, T. Pintér, Simon Van Belle, Daniel Vorobiof, Ricardo Duarte, Miguel Gil Gil, I. Bodrogi, Elizabeth Murray, Louise Yelle, Gunter Von Minckwitz, Stefan Korec, Peter Simmonds, Franco Buzzi, Rosario González Mancha, Gary Richardson, Euan Walpole, Monica Ronzoni, Michael MurawskyMay Alakl, Alessandro Riva, John Crown

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Abstract

Purpose: This phase III study compared docetaxel and doxorubicin in patients with metastatic breast cancer who had received previous alkylating agent-containing chemotherapy. Patients and Methods: Patients were randomized to receive an intravenous infusion of docetaxel 100 mg/m2 or doxorubicin 75 mg/m2 every 3 weeks for a maximum of seven treatment cycles. Results: A total of 326 patients were randomized, 165 to receive doxorubicin and 161 to receive docetaxel. Overall, docetaxel produced a significantly higher rate of objective response than did doxorubicin (47.8% v 33.3%; P = .008). Docetaxel was also significantly more active than doxorubicin in patients with negative prognostic factors, such as visceral metastases (objective response, 46% v 29%) and resistance to prior chemotherapy (47% v 25%). Median time to progression was longer in the docetaxel group (26 weeks v 21 weeks; difference not significant). Median overall survival was similar in the two groups (docetaxel, 15 months; doxorubicin, 14 months). There was one death due to infection in each group, and an additional four deaths due to cardiotoxicity in the doxorubicin group. Although neutropenia was similar in both groups, febrile neutropenia and severe infection occurred more frequently in the doxorubicin group. For severe nonhematologic toxicity, the incidences of cardiac toxicity, nausea, vomiting, and stomatitis were higher among patients receiving doxorubicin, whereas diarrhea, neuropathy, fluid retention, and skin and nail changes were higher among patients receiving docetaxel. Conclusion: The observed differences in activity and toxicity profiles provide a basis for therapy choice and confirms the rationale for combination studies in early breast cancer.

Original languageEnglish
Pages (from-to)2341-2354
Number of pages14
JournalJournal of Clinical Oncology
Volume17
Issue number8
Publication statusPublished - Aug 1999

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docetaxel
Doxorubicin
Breast Neoplasms
Drug Therapy
Febrile Neutropenia
Stomatitis
Alkylating Agents
Nails
Infection
Neutropenia
Intravenous Infusions

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Chan, S., Friedrichs, K., Noel, D., Pintér, T., Van Belle, S., Vorobiof, D., ... Crown, J. (1999). Prospective randomized trial of docetaxel versus doxorubicin in patients with metastatic breast cancer. Journal of Clinical Oncology, 17(8), 2341-2354.

Prospective randomized trial of docetaxel versus doxorubicin in patients with metastatic breast cancer. / Chan, Stephen; Friedrichs, Kay; Noel, Daniel; Pintér, T.; Van Belle, Simon; Vorobiof, Daniel; Duarte, Ricardo; Gil, Miguel Gil; Bodrogi, I.; Murray, Elizabeth; Yelle, Louise; Von Minckwitz, Gunter; Korec, Stefan; Simmonds, Peter; Buzzi, Franco; González Mancha, Rosario; Richardson, Gary; Walpole, Euan; Ronzoni, Monica; Murawsky, Michael; Alakl, May; Riva, Alessandro; Crown, John.

In: Journal of Clinical Oncology, Vol. 17, No. 8, 08.1999, p. 2341-2354.

Research output: Contribution to journalArticle

Chan, S, Friedrichs, K, Noel, D, Pintér, T, Van Belle, S, Vorobiof, D, Duarte, R, Gil, MG, Bodrogi, I, Murray, E, Yelle, L, Von Minckwitz, G, Korec, S, Simmonds, P, Buzzi, F, González Mancha, R, Richardson, G, Walpole, E, Ronzoni, M, Murawsky, M, Alakl, M, Riva, A & Crown, J 1999, 'Prospective randomized trial of docetaxel versus doxorubicin in patients with metastatic breast cancer', Journal of Clinical Oncology, vol. 17, no. 8, pp. 2341-2354.
Chan, Stephen ; Friedrichs, Kay ; Noel, Daniel ; Pintér, T. ; Van Belle, Simon ; Vorobiof, Daniel ; Duarte, Ricardo ; Gil, Miguel Gil ; Bodrogi, I. ; Murray, Elizabeth ; Yelle, Louise ; Von Minckwitz, Gunter ; Korec, Stefan ; Simmonds, Peter ; Buzzi, Franco ; González Mancha, Rosario ; Richardson, Gary ; Walpole, Euan ; Ronzoni, Monica ; Murawsky, Michael ; Alakl, May ; Riva, Alessandro ; Crown, John. / Prospective randomized trial of docetaxel versus doxorubicin in patients with metastatic breast cancer. In: Journal of Clinical Oncology. 1999 ; Vol. 17, No. 8. pp. 2341-2354.
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abstract = "Purpose: This phase III study compared docetaxel and doxorubicin in patients with metastatic breast cancer who had received previous alkylating agent-containing chemotherapy. Patients and Methods: Patients were randomized to receive an intravenous infusion of docetaxel 100 mg/m2 or doxorubicin 75 mg/m2 every 3 weeks for a maximum of seven treatment cycles. Results: A total of 326 patients were randomized, 165 to receive doxorubicin and 161 to receive docetaxel. Overall, docetaxel produced a significantly higher rate of objective response than did doxorubicin (47.8{\%} v 33.3{\%}; P = .008). Docetaxel was also significantly more active than doxorubicin in patients with negative prognostic factors, such as visceral metastases (objective response, 46{\%} v 29{\%}) and resistance to prior chemotherapy (47{\%} v 25{\%}). Median time to progression was longer in the docetaxel group (26 weeks v 21 weeks; difference not significant). Median overall survival was similar in the two groups (docetaxel, 15 months; doxorubicin, 14 months). There was one death due to infection in each group, and an additional four deaths due to cardiotoxicity in the doxorubicin group. Although neutropenia was similar in both groups, febrile neutropenia and severe infection occurred more frequently in the doxorubicin group. For severe nonhematologic toxicity, the incidences of cardiac toxicity, nausea, vomiting, and stomatitis were higher among patients receiving doxorubicin, whereas diarrhea, neuropathy, fluid retention, and skin and nail changes were higher among patients receiving docetaxel. Conclusion: The observed differences in activity and toxicity profiles provide a basis for therapy choice and confirms the rationale for combination studies in early breast cancer.",
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AU - Friedrichs, Kay

AU - Noel, Daniel

AU - Pintér, T.

AU - Van Belle, Simon

AU - Vorobiof, Daniel

AU - Duarte, Ricardo

AU - Gil, Miguel Gil

AU - Bodrogi, I.

AU - Murray, Elizabeth

AU - Yelle, Louise

AU - Von Minckwitz, Gunter

AU - Korec, Stefan

AU - Simmonds, Peter

AU - Buzzi, Franco

AU - González Mancha, Rosario

AU - Richardson, Gary

AU - Walpole, Euan

AU - Ronzoni, Monica

AU - Murawsky, Michael

AU - Alakl, May

AU - Riva, Alessandro

AU - Crown, John

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N2 - Purpose: This phase III study compared docetaxel and doxorubicin in patients with metastatic breast cancer who had received previous alkylating agent-containing chemotherapy. Patients and Methods: Patients were randomized to receive an intravenous infusion of docetaxel 100 mg/m2 or doxorubicin 75 mg/m2 every 3 weeks for a maximum of seven treatment cycles. Results: A total of 326 patients were randomized, 165 to receive doxorubicin and 161 to receive docetaxel. Overall, docetaxel produced a significantly higher rate of objective response than did doxorubicin (47.8% v 33.3%; P = .008). Docetaxel was also significantly more active than doxorubicin in patients with negative prognostic factors, such as visceral metastases (objective response, 46% v 29%) and resistance to prior chemotherapy (47% v 25%). Median time to progression was longer in the docetaxel group (26 weeks v 21 weeks; difference not significant). Median overall survival was similar in the two groups (docetaxel, 15 months; doxorubicin, 14 months). There was one death due to infection in each group, and an additional four deaths due to cardiotoxicity in the doxorubicin group. Although neutropenia was similar in both groups, febrile neutropenia and severe infection occurred more frequently in the doxorubicin group. For severe nonhematologic toxicity, the incidences of cardiac toxicity, nausea, vomiting, and stomatitis were higher among patients receiving doxorubicin, whereas diarrhea, neuropathy, fluid retention, and skin and nail changes were higher among patients receiving docetaxel. Conclusion: The observed differences in activity and toxicity profiles provide a basis for therapy choice and confirms the rationale for combination studies in early breast cancer.

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