Emerging role of taxanes in adjuvant and neoadjuvant therapy for breast cancer - The potential and the questions

Adjuvant systemic chemotherapy for breast cancer holds the key to further improvement in outcomes, but currently used chemotherapy regimens reduce the odds of death by only one third at best. The taxanes which have a unique mechanism of action and appear to be active against breast cancer that is resistant to anthracyclines, have generated a great deal of interest as additions to the treatment of operable breast cancer. Both paclitaxel and docetaxel have been tested for adjuvant and neoadjuvant chemotherapy, either in combination with anthracyclines or added sequentially before or after anthracycline-based treatment. The addition of paclitaxel to adjuvant therapy was initially reported to be beneficial, but its role is still unclear. Recent early reports on adding docetaxel to adjuvant and neoadjuvant regimens are promising, but longer follow-up is needed to confirm long-term improvement in survival.