Related Experiment Videos
Management of breast cancer: status and future trends
1Department of Breast and Gynecologic Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Abstract:
Metastatic breast cancer continues to be a challenge for the clinician. Heterogeneity of natural history and drug resistance have interfered with progress in treatment. Hormonal therapy is effective in 30% of patients, some of whom derive long-term benefit from sequential hormonal manipulations. Most patients have hormone-refractory tumors, and eventually all breast cancers become hormone resistant. Cytotoxic chemotherapy is the treatment of choice for these patients. Promising leads in recent clinical investigation include the development of dose-intensive therapies for induction or remission consolidation, biochemical modulation, development of new hormonal and cytotoxic agents, targeted therapy using immunologic or ligand-driven vehicles, and growth factor modulation. Among the encouraging clinical developments, the discovery of the taxanes represents an important step in improving the efficacy of cytotoxic therapy. Paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) produces objective regressions in 40% to 60% of patients with untreated or minimally treated metastatic breast cancer. The efficacy of this agent persists in patients with chemotherapy-refractory tumors, including those with anthracycline resistance. New paclitaxel-based combinations, especially those with doxorubicin, cisplatin, or vinorelbine, appear promising. This agent, alone or in combination, is also under evaluation in combined-modality strategies for early and advanced primary breast cancer.
Insights
Metastatic breast cancer treatment faces challenges from drug resistance. Taxanes, like paclitaxel, show significant efficacy, offering a promising advancement in chemotherapy for advanced breast cancer.
Area of Science:
- Oncology
- Pharmacology
Background:
- Metastatic breast cancer presents significant clinical challenges due to heterogeneous disease progression and acquired drug resistance.
- Hormonal therapy benefits a subset of patients, but most tumors eventually become hormone-refractory, necessitating alternative treatments like cytotoxic chemotherapy.
Purpose of the Study:
- To review recent clinical investigations and developments in metastatic breast cancer treatment.
- To highlight the role and efficacy of taxanes, particularly paclitaxel, in managing advanced and chemotherapy-refractory breast cancer.
Main Methods:
- Review of recent clinical investigations and therapeutic strategies for metastatic breast cancer.
- Evaluation of the efficacy of paclitaxel (Taxol) in patients with metastatic breast cancer, including those with prior chemotherapy exposure or resistance.
Main Results:
- Paclitaxel demonstrates objective regression rates of 40% to 60% in patients with untreated or minimally treated metastatic breast cancer.
- The efficacy of paclitaxel extends to patients with chemotherapy-refractory tumors, including those resistant to anthracyclines.
- Promising results are observed with paclitaxel-based combination therapies and its ongoing evaluation in early and advanced breast cancer treatment strategies.
Conclusions:
- Taxanes, exemplified by paclitaxel, represent a significant advancement in improving cytotoxic therapy efficacy for metastatic breast cancer.
- Paclitaxel offers a valuable therapeutic option, both as a single agent and in combination regimens, for patients with hormone-refractory or chemotherapy-resistant disease.