Chemotherapy of breast cancer: are the taxanes going to change the natural history of breast cancer?
Chemotherapy of breast cancer: are the taxanes going to change the natural history of breast cancer?
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DOI：
10.1517/14656566.1.2.187
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发表时间：
2000-01-01
影响因子：
3.2
通讯作者：
Mackey, J
中科院分区：
文献类型：
--
作者：
Nabholtz, J M;Tonkin, K;Mackey, J
在过去十年推出的新型化疗药物中，紫杉烷类药物已成为最强大的化合物，迄今为止的结果表明，它们将作为 20 世纪 90 年代的乳腺癌化疗药物在未来被人们所铭记。这两种紫杉烷类药物（紫杉醇、紫杉醇、百时美施贵宝和多西紫杉醇、泰索帝、罗纳-普朗克罗勒）具有一些共同特征，但在临床前特征以及最重要的临床特征方面也存在显着差异。主要临床差异与剂量和用药方案的药效比不同有关；紫杉醇和多西紫杉醇在含有蒽环类-紫杉烷的治疗方案中的可整合性不同，这是由于每种紫杉烷和蒽环类药物之间药代动力学相互作用的主要差异所致；每种紫杉烷和赫赛汀（HeR2Neu 抗体/曲妥珠单抗，Genentech/Roche）之间协同作用水平的潜在差异。在临床实践中，紫杉烷类药物现已成为先前化疗（尤其是蒽环类药物）失败后转移性乳腺癌的标准疗法。它们与蒽环类药物联合在晚期乳腺癌一线治疗中的作用正在显现，并为紫杉烷类药物在辅助治疗中的潜在作用提供了新的线索。然而，紫杉烷类药物对乳腺癌自然史的影响尚未确定，尽管结果趋势表明这些药物有可能显着改善乳腺癌的晚期治疗，最重要的是，辅助治疗。所有已完成或正在进行的一线转移性和辅助治疗的 III 期试验的结果将有助于确定紫杉烷类药物是否会进一步改善乳腺癌的结果。
Among the novel chemotherapeutic drugs introduced in the last decade, taxanes have emerged as the most powerful compounds and results available to date suggest that they will be remembered in the future as the breast cancer chemotherapy of the 1990s. The two taxanes (paclitaxel, Taxol, Bristol-Myers Squibb and docetaxel, Taxotere, Rhone-Poulenc Rorer) share some characteristics, but are also significantly different both in preclinical profile and, most importantly, in clinical characteristics. The main clinical differences are related to their different efficacy-toxicity ratio in relation to dose and schedule; the differing integrability of paclitaxel and docetaxel in anthracycline-taxane containing regimens, secondary to major differences in pharmacokinetic interactions between each taxane and the anthracyclines, and; the potential differences in level of synergism between each taxane and herceptin (HeR2Neu antibody/trastuzumab, Genentech/Roche). In clinical practice, the taxanes are now standard therapy in metastatic breast cancer after prior chemotherapy, in particular anthracyclines, has failed. Their role in combination with anthracyclines in first-line therapy of advanced breast cancer is emerging and sheds new light on the potential role of taxanes in the adjuvant setting. However, the impact of taxanes on the natural history of breast cancer is yet to be defined, despite the trend of results suggesting that these agents have the potential for significant improvements in advanced and, most importantly, adjuvant therapy of breast cancer. The results of all completed or ongoing Phase III trials in first-line metastatic and the adjuvant setting will help determine if taxanes will further improve the outcome of breast cancer or not.