A lower dose of docetaxel at 60 mg/m2 could be continued longer for controlling peripheral edema in patients with metastatic breast cancer

Docetaxel is a key drug for metastatic breast cancer (MBC). In patients with MBC, the treatment objective is durable response with minimum toxicity. In Japan, the approved dose of docetaxel is 60-70 mg/m(2) every 3 weeks, whereas 75-100 mg/m(2) docetaxel is common in the West. We retrospectively examined the prevalence of edema in patients with MBC who were treated with docetaxel. Seventy-seven patients received docetaxel at a dose of 60 mg/m(2) every 3 weeks with prophylactic premedication of dexamethasone, 8 mg daily for 3 days. Median follow-up time was 28 months (range 4.3-98). Overall response was 25% (95% CI 15-34). Median time to progression and median survival time from the beginning of any systemic therapy for metastatic disease were 10 and 66 months, respectively. Neutropenia was the most common toxicity, with grade 3-4 observed in 66%. Fifty-one percent of the patients experienced peripheral edema that could be controlled with oral diuretics. Grade 3 edema was observed in 4 patients only, and discontinuation because of edema was 9%. Other grade 3 or 4 toxicity was < 5%. Median cumulative dose of docetaxel to onset of peripheral edema was 480 mg/m(2) (range 60-780), and median cumulative given dose was 600 mg/m(2) (range 84-2,928). These results suggest that treatment with docetaxel at 60 mg/m(2) could be continued longer than the higher dose with manageable peripheral edema in patients with MBC. Further investigation is required to determine the superiority of low-dose docetaxel.