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Chemotherapy for metastatic breast cancer
Chemotherapy for metastatic breast cancer
Regardless of whether you had metastasized, or they have appeared for the first time in the arsenal of chemotherapy, there are many methods of treatment. Therefore, there is always a chance that it will be effective. For example, if a chemotherapy or a combination thereof have been ineffective, other chemotherapy drugs can give a very good effect.
Usually, before a combination of chemotherapy drugs used to treat metastatic performed single-drug treatment. This is due to the fact that this treatment gives a much less side effects than the use of multiple chemotherapeutic agents.
Chemotherapy is used in the following cases:
In the case of metastatic progression despite the use of hormonal or immune therapy.
In cases where the tumor is hormone-independent (ERts-negative).
In the case when the metastatic lesions of the liver or lungs.
Despite the fact that maybe you have already applied chemotherapy, there are various combinations of chemotherapy, so there is always the chance of a positive effect. With chemotherapy, as with any other treatment of tumors is very important to the quality of life. The use of "strong" or combinations of chemotherapy can cause significant side effects, so you can choose drugs with fewer side effects. Later, when the more powerful drugs are required, you can choose other chemotherapy drugs.
Usually, before starting the combined use of chemotherapeutic agents, we treat the individual drugs. For this purpose the taxanes (taxol, taxotere, or abraksan), adriamycin, or immune therapy drug Herceptin. Among the drugs used together, we note the taxanes and adriamycin. Schemes are usually chemotherapy (the first letters of the drug): TSAF, FAZ, TSEF or AC. Before using Taxol or Taxotere is usually appointed by the steroid drugs to reduce their side effects.
Among the chemotherapeutic agents that are assigned separately, can be identified:
Taxanes: Taxotere (dotsetkaskel), Taxol (paclitaxel) or abraksan (albumin-bound paclitaxel).
Adriamycin (doxorubicin) or paradox.
Xeloda (kapesitabin).
Navelbin (virelbin).
Gemzar (gemcitabine).
In most cases, the use of Taxotere, Taxol, or abraksana better than receiving adriamycin. The effectiveness of taxanes in the average is about 30% and ranges from 15 to 60%. Acceptance of this group of drugs is accompanied by a smaller nausea, vomiting and stomatitis than receiving adriamycin. However, some patients may be more effective adriamycin.
In one study it was found better efficacy compared to Taxotere taxol in the treatment of metastatic cancer. However, taking Taxotere is accompanied by a large number of side effects.
Other research shows that taxol and abraksan effective with fewer side effects. In addition, it is known that the use of abraksana once a week in small doses is also quite effective and with fewer side effects. Is currently under study with the combination of abraksana Herceptin (target-drug therapy).
Shows the effectiveness of Taxotere or Taxol at reception once a week in relatively small doses, as well as the low incidence of side effects (such as a decrease in blood cell counts, hair loss and neurological disorders), compared with the reception of every three weeks. In addition, abraksan can also be applied once a week and with prior use of steroids is not required.
The use of Gemzar and navelbina helps control the manifestations of the tumor without causing side effects (including hair loss). The effectiveness of these drugs is 20-40% and lasts for about 8 months.
The combined use of chemotherapy
Ideally, the combined use of chemotherapy: should destroy all types of cancer cells (because the tumor may be composed of different types of cell respond differently to chemotherapy). Drugs used together, should have few side effects. On the combined use of chemotherapy should not be produced resistance ("habituation" of cancer to the drugs). Combined application must have a reasonable number of side effects.
If you had never used chemotherapy, the doctor can choose the most appropriate combination of drugs by "trial and error" which efficiency is 35-60%: AT - Adriamycin (doxorubicin) and Taxotere (docetaxel). AC + T - Adriamycin and cyclophosphamide with or without (paclitaxel) or Taxotere. CMF - cyclophosphamide, methotrexate and fluorouracil. TSEF - cyclophosphamide (an analog of adriamycin) FAZ - fluorouracil, and cyclophosphamide. TAC - taxotere, Adriamycin and Cytoxan (cyclophosphamide). TSAF - cyclophosphamide, adriamycin, and fluorouracil. GET - Gemzar (gemcitabine), epirubicin, and taxol.
If growth continues metastasis
If you have received adriamycin despite marked tumor growth, it is worth paying attention to the following facts:
Taxotere is more effective than Taxol in the treatment of metastases.
Abraskan better tolerated than Taxol, so it does not require prior use of steroids.
The results of other studies suggest a greater efficiency with the combination of Taxotere Xeloda, Taxotere than one.
It also revealed the effectiveness of Gemzar combination with taxol than Taxol.
In case of failure of a combination of adriamycin with the taxanes, we recommend the use of these drugs and combinations: Xeloda (kapesitabin) Navelbin (vinorelbine) Gemzar (gemcitabine), CMF - cyclophosphamide, methotrexate and fluorouracil.
In the event of failure of these drugs and their combinations, the possible application of mitomycin, and vincristine.
As can be seen from the list of chemotherapy drugs that are used together, most often Taxol and Taxotere can be used with other drugs. In one study, which compared the use of Taxol and Taxotere in combination with other chemotherapeutic agents showed that the scheme, combining reception Taxotere was more effective in the treatment of metastatic breast cancer when Adriamycin is no longer exerted any effect on cancer. At the same time comparing the degree of reduction of the tumor, duration of response and overall survival.
