The results of recent clinical trials have shown that
docetaxel (
Taxotere; Rhône-Poulenc Rorer, Antony, France), like
paclitaxel (
Taxol; Bristol-Myers Squibb Oncology, Princeton, NJ), has high levels of activity in patients with
anthracycline-resistant
breast cancer. Agents that are at least partially non-cross-resistant with
anthracyclines are especially promising for the treatment of
breast cancer; the
taxoids (
docetaxel and
paclitaxel) are such agents. Although preclinical evaluations shows clear instances of strong cross-resistance (particularly in cells lines expressing the
P-glycoprotein, multidrug resistance), high response rates have been reported in patients with prior
anthracycline exposure and/or
anthracycline resistance. Phase I studies of
anthracycline and
taxoid combinations have been conducted. Excellent response rates have been noted in some of these studies. In some studies using regimens combining
doxorubicin and
paclitaxel, unanticipated toxicities have occurred, such as
typhlitis, as well as
congestive heart failure at lower than expected cumulative doses of
doxorubicin. Phase II and III studies of regimens including both
anthracyclines and
taxoids have been initiated.
Docetaxel and
paclitaxel appear to be valuable agents for use in
anthracycline-resistant
breast cancer patients, and may find a place in
anthracycline-containing combination regimens.