A feasibility study evaluating docetaxel-based sequential and combination regimens in the adjuvant therapy of node-positive breast cancer

BACKGROUND AND PURPOSE: Docetaxel is an active agent in the treatment of metastatic breast cancer. We evaluated the feasibility of docetaxel-based sequential and combination regimens as adjuvant therapies for patients with node-positive breast cancer. PATIENTS AND METHODS: Three consecutive groups of patients with node-positive breast cancer or locally-advanced disease, aged < or = 70 years, received one of the following regimens: a) sequential A-->T-->CMF: doxorubicin 75 mg/m2 q 3 weeks x 3, followed by docetaxel 100 mg/m2 q 3 weeks x 3, followed by i.v. CMF days 1 + 8 q 4 weeks x 3; b) sequential accelerated A-->T-->CMF: A and T were administered at the same doses q 2 weeks; c) combination therapy: doxorubicin 50 mg/m2 + docetaxel 75 mg/m2 q 3 weeks x 4, followed by CMF x 4. When indicated, radiotherapy was administered during or after CMF, and tamoxifen started after the end of CMF. RESULTS: Seventy-nine patients have been treated. Median age was 48 years. A 30% rate of early treatment discontinuation was observed in patients receiving the sequential accelerated therapy (23% during A-->T), due principally to severe skin toxicity. Median relative dose-intensity was 100% in the three treatment arms. The incidence of G3-G4 major toxicities by treated patients, was as follows: skin toxicity a: 5%; b: 27%; c: 0%; stomatitis a: 20%; b: 20%; c: 3%. The incidence of neutropenic fever was a: 30%; b: 13%; c: 48%. After a median follow-up of 18 months, no late toxicity has been reported. CONCLUSIONS: The accelerated sequential A-->T-->CMF treatment is not feasible due to an excess of skin toxicity. The sequential non accelerated and the combination regimens are feasible and under evaluation in a phase III trial of adjuvant therapy.

3-year results of docetaxel-based sequential and combination regimens in the adjuvant therapy of node-positive breast cancer: a pilot study.

BACKGROUND: Docetaxel has proven efficacy in metastatic breast cancer. In this pilot study, we explored the efficacy/feasibility of docetaxel-based sequential and combination regimens as adjuvant therapy of node-positive breast cancer. PATIENTS AND METHODS: From March 1996 till March 1998, four consecutive groups of patients with stages II and III breast cancer, aged < or = 70 years, received one of the following regimens: a) sequential Doxorubicin (A) --> Docetaxel (T) --> CMF (Cyclophosphamide+Methotrexate+5-Fluorouracil): A 75 mg/m q 3 wks x 3, followed by T100 mg/m2 q 3 wks x 3, followed by i.v. CMF Days 1+8 q 4 wks x 3; b) sequential accelerated A --> T --> CMF: A and T administered at the same doses q 2 wks with Lenograstin support; c) combination therapy: A 50 mg/m2 + T 75 mg/m2 q 3 wks x 4, followed by CMF x 4; d) sequential T --> A --> CMF: T and A, administered as in group a), with the reverse sequence. When indicated, radiotherapy was administered during or after CMF, and Tamoxifen after CMF. RESULTS: Ninety-three patients were treated. The median age was 48 years (29-66) and the median number of positive axillary nodes was 6 (1-25). Tumors were operable in 94% and locally advanced in 6% of cases. Pathological tumor size was >2 cm in 72% of cases. There were 21 relapses, (18 systemic, 3 locoregional) and 11 patients (12%) have died from disease progression. At median follow-up of 39 months (6-57), overall survival (OS) was 87% (95% CI, 79-94%) and disease-free survival (DFS) was 76% (95% CI, 67%-85%). CONCLUSION: The efficacy of these docetaxel-based regimens, in terms of OS and DFS, appears to be at least as good as standard anthracycline-based adjuvant chemotherapy (CT), in similar high-risk patient populations.

Proper-motion binaries in the Hipparcos catalogue: comparison with radial velocity data

Context. This paper is the last in a series devoted to the analysis of the binary content of the Hipparcos Catalogue. Aims. The comparison of the proper motions constructed from positions spanning a short (Hipparcos) or long time (Tycho-2) makes it possible to uncover binaries with periods of the order of or somewhat larger than the short time span (in this case, the 3 yr duration of the Hipparcos mission), since the unrecognised orbital motion will then add to the proper motion. Methods. A list of candidate proper motion binaries is constructed from a carefully designed χ2 test evaluating the statistical significance of the difference between the Tycho-2 and Hipparcos proper motions for 103 134 stars in common between the two catalogues (excluding components of visual systems). Since similar lists of proper-motion binaries have already been constructed, the present paper focuses on the evaluation of the detection efficiency of proper-motion binaries, using different kinds of control data (mostly radial velocities). The detection rate for entries from the Ninth Catalogue of Spectroscopic Binary Orbits (SB9) is evaluated, as well as for stars like barium stars, which are known to be all binaries, and finally for spectroscopic binaries identified from radial velocity data in the Geneva-Copenhagen survey of F and G dwarfs in the solar neighbourhood. Results. Proper motion binaries are efficiently detected for systems with parallaxes in excess of ∼20 mas, and periods in the range 1000-30 000 d. The shortest periods in this range (1000-2000 d, i.e. once to twice the duration of the Hipparcos mission) may appear only as DMSA/G binaries (accelerated proper motion in the Hipparcos Double and Multiple System Annex). Proper motion binaries detected among SB9 systems having periods shorter than about 400 d hint at triple systems, the proper-motion binary involving a component with a longer orbital period. A list of 19 candidate triple systems is provided. Binaries suspected of having low-mass (brown-dwarf-like) companions are listed as well. Among the 37 barium stars with parallaxes larger than 5 mas, only 7 exhibit no evidence for duplicity whatsoever (be it spectroscopic or astrometric). Finally, the fraction of proper-motion binaries shows no significant variation among the various (regular) spectral classes, when due account is taken for the detection biases. © ESO 2007.