European Journal of Cancer: Highlights of Issue 40:04

Reducing the odds of cardiotoxicity

Novel taxane and doxorubicin combination shows promise in breast cancer patients

The novel taxane, BMS-184476, and doxorubicin given as combined treatment for previously untreated or minimally treated breast cancer patients shows promising anti-tumour activity, Sessa and colleagues report in this issue. Furthermore, the combination does not result in the pharmacokinetic (PK) and biochemical interactions involved in the cardiotoxicity observed following treatment with paclitaxel/doxorubicin combinations. The authors conducted a phase IB and PK study of two different schedules of BMS-184476 (given, in combination with a fixed dose of 50 mg/m² doxorubicin, either once every 3 weeks or on days(d) 1 and 8 every 3 weeks). The maximum tolerated dose of the taxane was 30 mg/m² in the 3-weekly schedule and 35 mg/m²/week in the d1 and 8 schedule. Neutropenia was the most frequent toxicity observed with both schedules. For women with previously untreated or minimally treated breast cancer, none responded on the 3-weekly schedule. By contrast, 9 of 17 women responded on the d1 and 8 schedule. Some patients who were not responsive to the combination did respond to subsequent paclitaxel and doxorubicin treatment. "The combination of doxorubicin given on d1 and BMS-184476 on d1 and 8, every 3 weeks, appears to be worth testing in future studies", they said.

Differing views on complementary and alternate medicines

Only a few oncologists have positive views towards alternative medicines, a study reports in this issue. Risberg and colleagues conducted a multicentre survey of 828 Norwegian oncologists, nurses, clerks and therapeutic radiographers. Oncologists were less positive than the other groups about alternative medicines (4% had positive views compared with 33%, 55% and 32%, respectively). Females were also more positive (33% versus 14% males). By contrast, the participants were more positive about complementary methods.

Patients' preferences in quality of life measures

Patients with carcinoma of an unknown primary did not show a preference between two quality of life (QOL) questionnaires, authors report in this issue. Rodary and colleagues asked patients to state which of two commonly used QOL questionnaires (the European Organisation for Research and Treatment of Cancer Quality of Life Core 30 (EORTC QLQ-C30) and Functional Assessment of Chronic Illness Therapy (FACIT)) they preferred. The same proportion of patients (19%; 13/68) stated a preference for one of the questionnaires, whereas 54% (37/68) felt both were acceptable. This suggests the patients see the questionnaires as complementary, they said. As the EORTC QLQ-C30 had fewer unanswered questions, was perceived as less intrusive and had fewer items that were considered inadequately worded, the authors propose that this measurement should be preferentially chosen. Alternatively, if these measures are complementary, could they be combined, they asked?

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