Docetaxel: new preparation. No first-line use in metastatic breast cancer

(1) For the treatment of metastatic breast cancer, the reference first-line cytotoxic chemotherapy is an anthracycline-based combination such as doxorubicin + cyclophosphamide. (2) The clinical file on docetaxel in this indication mainly comprises data from a comparative trial of doxorubicin + docetaxel versus doxorubicin + cyclophosphamide in 429 patients. (3) In this trial the doxorubicin + docetaxel combination failed to increase the duration or quality of survival relative to the doxorubicin + cyclophosphamide combination, whereas its adverse effect profile was somewhat poorer (notably with a risk of severe neutropenia). (4) Docetaxel currently has no place in this setting.