Adjuvant treatment of breast cancer with taxanes

Adjuvant chemotherapy plays a significant role in improving survival in patients with breast cancer. So far, anthracycline-based combination chemotherapy regimens have demonstrated an advantage over standard cyclophosphamide, methotrexate and 5-fluorouracil (CMF) in the adjuvant treatment of breast cancer. The taxanes clocetaxel and paclitaxel are 2 of the most active cytotoxic agents and are now under investigation in the adjuvant setting in a large series of randomized clinical trials that will enroll no less than 56,000 women of whom 22,000 women will contribute to paclitaxel-related questions and 34,000 to docetaxel-related questions. However, the optimal patient population for receiving a taxanecontaining adjuvant therapy regimen is still to be evaluated. The use of taxanes in sequence or in combination with anthracyclines is justified in the presence of nodepositive, estrogen receptor-negative tumors, HER2 overexpression or contraindications for the use of anthracyclines. A recommendation concerning optimal taxane schedules cannot be made yet.