326PD - Paclitaxel-based versus docetaxel-based regimens in metastatic breast cancer: a systematic review and meta-analysis of randomized controlled trials

Date 01 October 2012
Event ESMO Congress 2012
Session Breast cancer, locally advanced and metastatic
Topics Anticancer agents
Breast Cancer
Biological therapy
Presenter Wei-Xiang Qi
Authors W. Qi, Y. Yao, Z. Shen, F. Lin, Y. Sun, D. Min, A. He, L. Tang
  • Dept. Of Oncology, the Sixth People's Hospital Shanghai Jiaotong University, 200233 - Shanghai/CN



Docetaxel and paclitaxel show significant clinical activity in metastatic breast cancer (MBC) and have been approved for MBC by U.S. Food and Drug Administration, but it is still unclear whether paclitaxel-based regimen improves outcome over docetaxel-based regimen in patients with MBC. We therefore performed a meta-analysis of randomized controlled trials that compared paclitaxel-based with docetaxel-based regimens in MBC.


We systematically searched for randomized controlled trials that comparing paclitaxel-based with docetaxel-based regimens in patients with metastatic breast cancer in PUBMED, EMBASE and Cochrane databases. Abstracts presented at the conference were also searched. The primary endpoint was overall survival (OS). Secondary endpoints were progression free survival (PFS), time to progression (TTP), overall response rate (ORR), and grade 3 or 4 toxicity. Data were extracted from the studies by two independent reviewers. The meta-analysis was performed by Stata version 12.0 software (Stata Corporation, College Station, TX, USA).


Seven eligible trials involving 1694 patients with MBC were selected. Our meta-analysis results showed that paclitaxel-based regimen was comparable to docetaxel-based regimen in terms of OS (HR: 0.87, 95%CI: 0.60-1.27, p = 0.476),PFS(HR:0.76,95%CI:0.58-1.00, p = 0.052), TTP(HR: 1.13, 95%CI: 0.81-1.58, p = 0.459), and ORR(RR:1.01, 95%CI: 0.88-1.15, p = 0.915), but less grade 3 or 4 adverse events including anemia(RR:0.64,95%CI:0.44-0.94,p = 0.023), neutropenia (RR:0.74,95%CI:0.58-0.93, p = 0.011), febrile neutropenia (RR:0.38, 95%CI:0.15-0.96, p = 0.041), thrombopenia (RR:0.62, 95%CI: 0.41-0.96,p = 0.033),mucositis (RR:0.082, 95%CI:0.025-0.27,p = 0.000),diarrhea(RR:0.194,95%CI:0.081-0.47,p = 0.000) and fatigue(RR:0.434,95%CI:0.20-0.96,p = 0.039) were observed in paclitaxel-based regimen.


The present systematic review and meta-analysis demonstrate that both taxanes-based regimens show comparable efficacy for patients with MBC, and paclitaxel-based regimen is associated with less toxicity and better tolerability, especially in older patients and when used in weekly regimens.


All authors have declared no conflicts of interest.