Integration of docetaxel into adjuvant breast cancer treatment regimens

Adjuvant chemotherapy is an integral component of the multidisciplinary curative treatment of primary breast cancers. The experience of the last 3 decades indicates that anthracycline-containing regimens provide the most effective cytotoxic treatment for this purpose. The development of the taxanes over the past 10 years represents substantial progress, and taxane-containing regimens are widely used for the treatment of metastatic breast cancer. Most ongoing clinical trials of adjuvant chemotherapy include a taxane-related question. The docetaxel (Taxotere)-containing regimens were developedfollowing one of three important strategies: (1) the sequential administration of docetaxel to existing, commonly used combinations; (2) the simultaneous addition of docetaxel to an existing regimen; and (3) the substitution of docetaxelfor one of the drugs included in standard combinations. These three approaches are under intense investigation by large multicenter, multinational clinical trials. The results of these phase III, prospective, randomized trials will establish the contribution of docetaxel to the curative treatment of breast cancer and will determine the optimal method of incorporating this drug into standard adjuvant therapy.