Taxol followed by FAC – pro

NCCN does not list the regimen of a taxane followed by FAC but only AC followed by a taxane.

Since 1998, the standard of adjuvant care for patients with node-positive breast cancer in the United States and other parts of the world has been treatment with doxorubicin and cyclophosphamide followed by the taxane paclitaxel. This regimen was first administered on a schedule of once every three weeks and then, more recently, once every two weeks, after a comparative trial demonstrated improved efficacy (a 7 percent absolute improvement in disease-free survival and a 2 percent improvement in overall survival at three years) with the schedule involving more frequent administration (referred to as dose-dense therapy).

There are cetainly reports of the regimen proposed here and is advocated by certain physicans at MD Anderson but it is not standard of care and not supported by guidelines.

Seidman AD, Berry D, Cirrincione C, Harris L, Muss H, Marcom PK, Gipson G, Burstein H, Lake D, Shapiro CL, Ungaro P, Norton L, Winer E, Hudis C.Randomized phase III trial of weekly compared with every-3-weeks paclitaxel for metastatic breast cancer, with trastuzumab for all HER-2 overexpressors and random assignment to trastuzumab or not in HER-2 nonoverexpressors: final results of Cancer and Leukemia Group B protocol 9840.J Clin Oncol. 2008 Apr 1;26(10):1642-9. Comment in: J Clin Oncol. 2008 Apr 1;26(10):1585-7.

Marjorie C. Green, Aman U. Buzdar, Terry Smith, Sonja Eva Singletary, Cynthia Carter, Marguerite F. Rosales, Daniel J. Booser, Lajos Pusztai, Massimo Cristofanilli, Richard Theriault, Nuhad K Ibrahim, Francisco J. Esteva, Henry Kuerer, Kelly Hunt, Marsha McNeese, Eric Strom, Thomas A. Buchholz, Frederick Ames, Gabriel N. Hortobagyi, The University of Texas M. D. Anderson Cancer Center, Houston, TX.Proc Am Soc Clin Oncol 20: 2001 (abstr 129)

Breast Cancer (MD Anderson Cancer Care Series) (Paperback)
by Kelly K. Hunt (Editor), Geoffrey L. Robb (Editor), Eric A. Strom (Author), Springer, 2001. p.318

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