Ann Oncol. 2008 Nov;19(11):1837-41. Epub 2008 Jun 18.
Is risk of central nervous system (CNS) relapse related to adjuvant taxane treatment in node-positive breast cancer? Results of the CNS substudy in the intergroup Phase III BIG 02-98 Trial.
Pestalozzi BC,
Francis P,
Quinaux E,
Dolci S,
Azambuja E,
Gelber RD,
Viale G,
Balil A,
Andersson M,
Nordenskjöld B,
Gnant M,
Gutierrez J,
Láng I,
Crown JP,
Piccart-Gebhart M;
BIG 02-98 Collaborative Group.
Department of Oncology, University Hospital, Zurich, Switzerland.
bernhard.pestalozzi@usz.ch
BACKGROUND: Breast cancer central nervous system (CNS) metastases are an increasingly important problem because of high CNS relapse rates in patients treated with trastuzumab and/or taxanes. PATIENTS AND METHODS:
We evaluated data from 2887 node-positive breast cancer patients randomised in the BIG 02-98 trial comparing anthracycline-based adjuvant chemotherapy (control arms) to anthracycline-docetaxel-based sequential or concurrent chemotherapy (experimental arms).
After a median follow-up of 5 years, 403 patients had died and detailed information on CNS relapse was collected for these patients. RESULTS:
CNS relapse occurred in 4.0% of control patients and 3.7% of docetaxel-treated patients. CNS relapse occurred in 27% of deceased patients in both treatment groups. CNS relapse was usually accompanied by neurologic symptoms (90%), and 25% of patients with CNS relapse died without evidence of extra-CNS relapse. Only 20% of patients survived 1 year from the diagnosis of CNS relapse. Prognosis of CNS relapse was worse for patients with meningeal carcinomatosis when compared with brain metastases. Unexpected findings included a higher rate of positive cerebrospinal fluid cytology (8% versus 3%) and more frequent use of magnetic resonance imaging for diagnosis (47% versus 30%) in the docetaxel-treated patients. CONCLUSION:
There is no evidence that adjuvant docetaxel treatment is associated with an increased frequency of CNS relapse.
PMID: 18562328 [PubMed - indexed for MEDLINE]