University of Virginia Health System

Breast Cancer Patients Benefit from Weekly Taxol Doses

Women who take the drug Taxol® weekly after receiving chemotherapy for 12 weeks live longer compared with women who take four Taxol treatments every three weeks, according to a report in the New England Journal of Medicine.

The study also evaluated another medication in the same family, called Taxotere® (docetaxel), but found that weekly Taxol (paclitaxel) was more effective.

"The findings suggest that weekly Taxol for 12 weeks is more effective than four cycles of Taxol and should be considered a new standard," says study author Dr. Joseph A. Sparano.

Physicians Continue to Learn More

"We have been giving women with metastatic breast cancer weekly paclitaxel and know that it is effective," says Paula Fracasso, M.D., Ph.D., FACP, the Penniston Professor of Women's Oncology and Deputy Director of the University of Virginia Cancer Center. "We will now be extending this weekly treatment to women with node-positive and high-risk, node-negative breast cancer."

Women with breast cancer who receive medications known as taxanes after standard chemotherapy have a substantially reduced risk of recurrence and of death. The other taxane, Taxotere (docetaxel), is more potent than Taxol.

About a decade ago, a study showed that adding Taxol to standard chemotherapy reduced the risk of breast cancer recurrence. The medication was subsequently approved in the U.S., with the standard of care being four doses once every three weeks.

A later study showed that giving the same dosage every two weeks was more effective than every three weeks, so that became common practice.

Study's Findings Change Approach

In the meantime, questions were raised about whether taxanes were effective for the most common type of breast cancer, which is hormone-receptor positive and HER2-negative.

"It raised a lot of concerns," says Sparano, who works at Montefiore-Einstein Cancer Center. "People were saying, 'Wait a minute. We thought Taxol was very effective, and maybe it's not as effective as we thought, and are we treating people unnecessarily?'"

In the new study, Sparano and his colleagues compared the effectiveness of giving standard chemotherapy (doxorubicin and cyclophosphamide at three-week intervals) plus four cycles or doses of Taxol every three weeks compared with every week for 12 doses at a lower dose.

They also compared Taxol with Taxotere (four cycles every three weeks), as well as Taxotere given either every three weeks for four treatments or weekly for 12 treatments.

The study involved almost 5,000 women.

There were no significant differences in survival between those treated with Taxol and those treated with Taxotere or between the groups treated weekly or every three weeks.

There was no indication that weekly Taxol was less effective in women with hormone-receptor-positive, HER2-negative breast cancer.

"Taxol is effective in patients with one or more common subtypes [of breast cancer] and, if it is going to be used in that population, should be delivered weekly for 12 weeks rather than every three weeks for four treatments," explains Sparano.

Based on this study, women at UVA Cancer Center with node-positive and high-risk, node-negative breast cancer will preferentially be treated with 12 weekly cycles of paclitaxel instead of four cycles of paclitaxel every three weeks, Fracasso says.

To read a patient story, get additional information on breast cancer treatment or learn about UVA's Breast Care Program, visit www.uvahealth.com. 

UVA also offers a free, confidential risk assesment through the region's only High Risk Care program to determine if you have a higher-than-normal personal risk of developing breast or ovarian cancer. This free service is particularly encouraged for women with a strong family history of breast or ovarian cancer. To arrange the free screening, call 434-982-0808.

Women can learn more about their unique risks for heart disease - and how to better manage those risks - through Live Red, a new UVA heart-health initiative. You'll learn how heart attack symptoms can be different for women than for men, and you can take an online risk assessment to learn your personal heart disease risk factors.

There, you can sign up for Club Red, our free heart-healthy club for women. Benefits include tips from UVA healthcare providers and a gift package to help you live red in style.

Always consult your physician for more information.