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Benefit risk assessment and update on the use of docetaxel in the management of breast cancer

Authors Alken S, Kelly CM

Received 1 June 2013

Accepted for publication 21 August 2013

Published 14 October 2013 Volume 2013:5 Pages 357—365

DOI https://doi.org/10.2147/CMAR.S49321

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2


Scheryll Alken, Catherine M Kelly

Department of Medical Oncology, Mater Misericordiae University Hospital, Dublin, Ireland

Abstract: The objective of this paper is to review the data supporting the use of docetaxel in the treatment of breast cancer, focusing on pharmacokinetics, efficacy in adjuvant and metastatic trials alone and in combination with chemotherapeutic and targeted agents, and the toxicity of docetaxel in comparison to paclitaxel. Docetaxel is a semisynthetic product derived from the European yew tree Taxus baccata L. It promotes the assembly of microtubules, stabilizes them, and thereby prevents their depolymerization. Docetaxel has been incorporated into neo-adjuvant chemotherapy regimens, both with and without anthracyclines. The inclusion of taxanes such as docetaxel in polychemotherapy regimens in early breast cancer is associated with a statistically significant reduction in mortality. As a single agent, docetaxel is highly active in the treatment of metastatic breast cancer. In first-line treatment of metastatic breast cancer, the combination of docetaxel and capecitabine was associated with an improvement in overall survival; however, toxicity was higher. The toxicity profile of docetaxel has been well documented and is predictable; the most frequent adverse effects are neutropenia and febrile neutropenia. Taxane-specific adverse effects, such as peripheral neuropathy, are also expected but are manageable with appropriate dosing and scheduling.

Keywords: taxanes, docetaxel, clinical trial, adverse effects, peripheral neuropathy, neutropenia

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