Taxanes in primary systemic treatment of breast cancer

Primary systemic treatment today represents a new option for patients with operable breast cancer and is equally effective as conventional adjuvant chemotherapy. Improving surgical options is the most important indication for choosing this approach. The highest chance for breast conserving surgery can be obtained when a sequence of adriamycin and cyclophosphamide (AC) is followed by docetaxel. This has been shown in the Geparduo and NSABP-B27 trial. New approaches are considering individual tailoring of treatment according to either early response of the primary breast tumor (Gepartrio) or pharmacogenetic testing on the tumor tissue.