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Efficacy of Docetaxel 60 mg/m² in Patients With Metastatic Breast Cancer According to the Status of Anthracycline Resistance

From the Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.

Address reprint requests to Toru Watanabe, MD, Department of Medical Oncology, National Cancer Center Hospital, 1-1 Tsukiji 5 chome, Chuo-ku, Tokyo 104-0045, Japan; email twatanab{at}ncc.go.jp

PURPOSE: To evaluate the efficacy of docetaxel 60 mg/m² in metastatic breast cancer (MBC) according to the status of anthracycline resistance.

PATIENTS AND METHODS: Ninety-nine patients with anthracycline-resistant MBC were treated with docetaxel 60 mg/m² intravenously for a 90-minute period every 3 to 4 weeks. Anthracycline resistance was defined as primary and secondary resistance. Primary resistance was defined as progression during or within 6 months after completion of adjuvant anthracycline, and no MBC response to a first-line regimen that contained anthracycline. Secondary resistance was defined as progression after a documented clinical response to a first-line anthracycline treatment for MBC. Secondary resistance was further divided into three categories: (1) absolute resistance, or progression during treatment with anthracycline after a period of response; (2) relative resistance, or progression within 6 months after anthracycline administration ended; and (3) sensitive regrowth, or progression more than 6 months after the conclusion of anthracycline administration.

RESULTS: The response rate in the 99 patients was 35.4% (95% confidence interval, 30.1% to 44.8%). The response rates according to the status of anthracycline resistance were as follows: primary resistance (n = 46), 19.6%; secondary resistance (n = 53), 49.1% (absolute resistance [n = 16], 56.3%); relative resistance (n = 17), 47.1%; and sensitive regrowth (n = 20), 45.0%. The median time to treatment failure in patients with primary resistance was 2.9 months, compared with 5.2 months in patients with secondary resistance (P = .0022).

CONCLUSION: Docetaxel at a dose of 60 mg/m² seemed to be effective in MBC with secondary resistance to anthracycline. The status of anthracycline resistance is important for the prediction of response to second-line treatment with docetaxel.

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