Taxane containing regimens for metastatic breast cancer

  • Review
  • Intervention




It is generally accepted that taxanes are among the most active chemotherapy agents in the management of metastatic breast cancer.


To identify and review the randomised evidence comparing taxane containing chemotherapy regimens with regimens not containing a taxane in the management of women with metastatic breast cancer.

Search methods

The specialised register maintained by the Editorial Base of the Cochrane Breast Cancer Group was searched on 12 March 2004 using the codes for "advanced breast cancer", "chemotherapy". Details of the search strategy applied by the Group to create the register, and the procedure used to code references, are described in the Group's module on the Cochrane Library.

Selection criteria

Randomised trials comparing taxane-containing chemotherapy regimens with regimens not containing taxanes in women with metastatic breast cancer.

Data collection and analysis

Data were collected from published trials. Studies were assessed for eligibility and quality, and data were extracted, by two independent reviewers. Hazard ratios were derived for time-to-event outcomes where possible, and a fixed effect model was used for meta-analysis. Response rates were analysed as dichotomous variables. Toxicity and quality of life data were extracted where present.

Main results

Twenty one eligible trials were identified of which 12 have published time-to-event data and 16 have reported response data. The quality of randomisation was generally not described.

An estimated 2621 deaths in 3643 randomised women demonstrate a statistically significant difference in favour of taxane-containing regimens with a HR for overall survival of 0.93 (95% CI=0.86-1.00, p=0.05) and no statistically significant heterogeneity. If the analysis is restricted to trials of firstline chemotherapy the HR changes to 0.92 and is no longer statistically significant (95% CI 0.84-1.02, p=0.11). There was also a significant difference in favour of taxanes in relation to time to progression (overall HR 0.92, 95%CI 0.85-0.99, p=0.02) and overall response in assessable women (overall OR 1.34, 95%CI 1.18-1.52, p<0.00001) however there was strong statistical evidence of heterogeneity (P<0.00001), probably reflecting the varying efficacy of the comparator regimens used in the trials.

Authors' conclusions

When all trials are considered, taxane-containing regimens appear to improve overall survival, time to progression and overall response in women with metastatic breast cancer. The degree of heterogeneity encountered indicates that taxane-containing regimens are more effective than some, but not all non-taxane-containing regimens.














21個符合條件的試驗被引用,其中包括12個有發表時間對事件的資料,與16個有報告回應資料,一般由於並未說明隨機分派的細節,故無法評價其分派品質。 在3643個隨機分派的婦女中,估計有2621個死亡,顯示有利於有含taxane的療法,具統計學上明顯差異,整體存活的風險比率是0.93(百分之九十五的信賴區間介於0.86與1.00之間,p值等於0.05),異質性分析不具統計意義。如果分析僅限制於第一線化學療法的試驗,風險比率則改為0.92,而且不再具有統計學上地顯著(百分之九十五的信賴區間介於0.84與1.02之間,p值等於0.11)。另關於疾病進展時間(整體的勝算比是1.34,百分之九十五的信賴區間介於1.18與1.52之間,p值等於0.02),及在評估婦女的整體反應(整體的風險比率是0.92,百分之九十五的信賴區間介於0.85與0.99之間,p值小於0.00001),均有明顯差異利於taxanes;然而統計學上具有高度的試驗異質性,或許反映在不同試驗中,使用的比較療法不同療效。。





此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。


在有晚期乳癌的婦女,包含taxane的化學療法能改進存活和疾病進展,但需要更多的研究在哪個療法最有幫助。 晚期(轉移)乳癌是已經擴散出乳房以外的癌症;治療通常涉及到化學療法(抗癌症的藥)來設法降低癌症;藥物可以被單獨或者結合在一起使用;Paclitaxel和docitaxel是被屬於taxanes類的化學療法藥物;Taxanes可抑制癌細胞分裂和再生;副作用能包括噁心,嘔吐和掉髮;可事先使用藥物治療來降低過敏反應。本回顧發現,包含taxanes的化學療法可改善存活,並且減少晚期乳癌的進展,然而需要更進一步的試驗來確定哪種化學療法是最有效的。

Plain language summary

Taxane containing regimens for metastatic breast cancer

Chemotherapy including taxane could improve survival and disease progression in women with advanced breast cancer, but more research is needed on which regimens help most. Advanced (metastatic) breast cancer is cancer that has spread beyond the breast. Treatment usually involves chemotherapy (anti-cancer drugs) to try to reduce the cancer. Drugs can be used alone or in combination. Paclitaxel and docitaxel are chemotherapy drugs known as taxanes. Taxanes can inhibit cancer cells from dividing and reproducing. Adverse effects can include nausea, vomiting and hair loss, as well as allergic reactions which can be reduced by premedication. The review found that chemotherapy including taxanes improved survival and decreased the progression of advanced breast cancer. Further trials are needed to determine which chemotherapy regimens are most effective.