Single-agent paclitaxel as first-line treatment of metastatic breast cancer: the British experience

The efficacy and safety of paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) was studied as first-line treatment for 30 consecutive patients with metastatic breast cancer. All patients had received adjuvant/neoadjuvant chemotherapy, 22 had prior hormonal therapy, and 26 had received previous adjuvant radiotherapy. Paclitaxel 225 mg/m2 was given as a 3-hour infusion without colony-stimulating factor support at 3-week intervals without excessive dose reduction or delays. The most common nonhematologic toxicities were alopecia (grade 3 in 29 patients) and peripheral neuritis (grade 2 or 3 in 14 patients). The objective response rate was 60% and responses were seen in all disease sites. The median duration of overall response was 30 weeks (range, 15 to 75+ weeks) and the estimated median survival time for all patients was 56 weeks (range, 1 to 82+ weeks). The response rate and survival times seen with single-agent paclitaxel are encouraging. Future studies must explore paclitaxel in combination with other regimens, with the hope that results will improve further.