Weekly dose-dense treatment with taxanes in metastatic breast cancer

Weekly dose-dense cytotoxic treatment with taxanes is a promising option in the treatment of metastatic breast cancer. This retrospective analysis reflects our experiences in efficacy and toxicity using weekly administration of taxanes. In this setting 21 heavily pretreated patients with metastatic breast cancer received either paclitaxel (n = 11) at an initial dose of 70-100 mg/m², or docetaxel (n = 10) at a dose of 35 mg/m² intravenously. 110 infusions of docetaxel were administered in 10 patients (median 11 infusions/patient, range: 3-25). Overall response rate was 40% and median response duration was 32 weeks (range 3-48 weeks). The worst non-hematologic toxicity was grade III alopecia. Hematologic toxicity occured in 28/110 cycles with grade I/II and 1/110 grade III leucopenia, in 17/110 cycles grade I/II and in 1/110 grade III thrombocytopenia; grade I/II anemia occured in 0/110 cycles and neurotoxicity grade I/II in 43/110 and grade III in 3/110 cycles. No grade IV toxicities were observed. In the second group 11 patients were treated with 126 infusions of paclitaxel (median 12 cycles/patient, range 6-25). The overall response rate was 55%, median duration of response was 21 weeks (range 8-30 weeks). The main toxicity was grade I/II alopecia. In 21/126 cycles grade I/II and in 1/126 grade III leucopenia, no thrombocytopenia, 41/126 grade I/II and 1/126 grade IV anemia and 41/126 grade I/II neurotoxicity was recorded. Paclitaxel and docetaxel both are effective in the treatment of metastatic breast cancer with low toxicity and high efficacy resulting in a tolerable therapeutic index in heaviliy pretreated patients with metastatic breast cancer.