A Cochrane review (abstract «»1, review «Taxane‐containing regimens for metastatic breast cancer»2) included 28 studies involving a total of 6 871 subjects. There was a statistically significant difference in favour of taxane-containing regimens for overall survival, time to progression, and overall response rate «Table 1. Taxane-containing regimens for metastatic breast cancer compared with no taxane»1. The considerable heterogeneity found probably reflects the varying efficacy of the comparator regimens used in the trials. Taxanes were associated with an increased risk of neurotoxicity (RR 4.84, 95% CI 3.18 to 7.35, P < 0.00001, 24 studies) and hair loss (RR 2.37, 95% CI 1.45 to 3.87, P = 0.0006, 11 studies) but less nausea/vomiting compared to non-taxane-containing regimens (RR 0.62, 95% CI 0.46 to 0.83, P = 0.001, 26 studies). For quality of life measures, none of the individual studies reported a difference in overall or any of quality of life subscales between taxane-containing and non-taxane chemotherapy regimens.
See also the breast cancer guideline of American society of oncology «Korde LA, Somerfield MR, Carey LA et al. Neoadjuvant Chemotherapy, Endocrine Therapy, and Targeted Therapy for Breast Cancer: ASCO Guideline. J Clin Oncol 2021;39(13):1485-1505. »2.
| Outcome | Relative effect (95% CI) | Participants (studies) |
|---|---|---|
| Overall Survival | 0.93 (0.88 to 0.99) | 6 008 (23) |
| Time to Progression | 0.92 (0.87 to 0.97) | 5 960 (22) |
| Time to Treatment Failure | 0.90 (0.82 to 0.98) | 1 724 (5) |
| Overall Response Rate | 1.20 (1.14 to 1.27) | 6 999 (29) |
| Toxicity | 1.00 (0.63 to 1.57) | 5 517 (22) |
Comment: The quality of evidence is downgraded by inconsistency (variability in results across studies and heterogeneity in studied interventions).