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[New drugs in metastatic breast cancer--1997]
1Dept. of Surgery, Keio University, Tokyo, Japan.
Abstract:
The introduction of new drugs may offer significant hope for improvement in the treatment of breast cancer. They include new cytotoxic agents such as Taxanes, Topoisomerase inhibitor, MDR modulator, new hormone such as 3rd generation nonsteroidal aromatase inhibitor, pure antiestrogen for patients with refractory metastatic breast cancer and new bisphosphonates for those who have metastases to bone. Therefore, some reports evaluating such new drugs were reviewed. Japanese studies revealed response rate of Taxanes in the treatment of metastatic breast cancer as follows; Six out of 22 (27%) with 1 CR for 24 hours infusion, 21 out of 52 (34%) with 2 CR for 3 hours infusion of paclitaxel respectively, 21 out of 31 (41%) with 2 CR for 1 hour infusion, and 32 out of 72 (44%) with 5 CR for 1 hour infusion of Docetaxel, In addition, the MTD of the combination was reached at dose level with 60 mg/sqm of Docetaxel and 400 mg/sqm of cyclophosphamide. As regards hormone therapy, thirty four out of 176 (19%) with 5 CR were observed in phase II study of Fadrozol but results from the phase II study of 3rd generation aromatase inhibitor is not yet accomplished in Japan. However, any european reports did not show a difference in response rate in patients with tamoxifen refractory breast cancer between newer aromatase inhibitor and megasterol, and a good choice of hormones in the treatment of metastatic breast cancer appears to be difficult.
Insights
New cytotoxic agents like Taxanes and novel hormone therapies show promise for metastatic breast cancer treatment. Further research is needed to optimize hormone therapy choices for refractory cases.
Area of Science:
- Oncology
- Pharmacology
Background:
- Breast cancer treatment is evolving with new drug classes.
- Metastatic breast cancer presents significant treatment challenges.
Purpose of the Study:
- To review recent studies on novel drugs for breast cancer.
- To evaluate the efficacy of new cytotoxic agents and hormone therapies.
Main Methods:
- Review of Japanese and European clinical studies.
- Analysis of response rates for Taxanes (paclitaxel, docetaxel) and hormone therapies (Fadrozol, aromatase inhibitors).
Main Results:
- Taxanes demonstrated varying response rates in metastatic breast cancer.
- Docetaxel and cyclophosphamide combination reached its maximum tolerated dose.
- Fadrozol showed a 19% response rate; newer aromatase inhibitors' efficacy is pending in Japan.
- European studies found no significant difference between newer aromatase inhibitors and megasterol in tamoxifen-refractory breast cancer.
Conclusions:
- Newer drugs, including Taxanes and hormone therapies, offer potential for breast cancer treatment.
- Optimal hormone therapy selection for metastatic and refractory breast cancer remains challenging.