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Annals of Oncology Advance Access originally published online on November 15, 2007
Annals of Oncology 2008 19(3):461-464; doi:10.1093/annonc/mdm527
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© The Author 2007. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

breast cancer

Survival outcome and cost-effectiveness with docetaxel and paclitaxel in patients with metastatic breast cancer: a population-based evaluation

T. Vu1, S. Ellard2, C. H. Speers3, S. C. M. Taylor1, M. L. de Lemos1,*, F. Hu1, K. Kuik2 and I. A. Olivotto4

1 Provincial Systemic Therapy Program
2 Centre for the Southern Interior
3 Breast Cancer Outcomes Unit, BC Cancer Agency, Vancouver
4 Breast Cancer Outcomes Unit, BC Cancer Agency and University of British Columbia, Victoria, British Columbia, Canada

* Correspondence to: Dr M. L. de Lemos, Provincial Systemic Therapy Program, BC Cancer Agency, Vancouver, British Columbia, Canada. Tel: +1-604-877-6098; Fax: +1-604-708-2024; E-mail: mdelemos{at}bccancer.bc.ca

Background: A randomized controlled trial showed longer overall survival (OS) with docetaxel compared with paclitaxel in metastatic breast cancer patients with prior exposure to anthracycline. We report a similar comparison using population-based data.

Methods: Data on patients treated with single-agent paclitaxel or docetaxel were retrospectively reviewed. OS was compared using a two-tailed log-rank test and expressed as Kaplan–Meier plots. A cost-effectiveness analysis was carried out using cost/patient and OS.

Results: Four hundred and thirty-five patients met eligibility criteria. Prognostic factors were balanced between docetaxel and paclitaxel groups. Median OS was significantly longer for docetaxel versus paclitaxel [10.9 versus 8.3 months; hazard ratio 0.76; 95% confidence interval (CI), 0.62–0.92; P = 0.006]. The median number of cycles administered were four (docetaxel) and three (paclitaxel). The incremental cost-effectiveness ratio was $2434/per month of median survival gained. In the sensitivity analysis, the results were robust except that paclitaxel dominated when the low end of the 95% CI of survival for docetaxel was compared with the high end for paclitaxel.

Conclusion: This population-based study corroborated the randomized trial's conclusion that for patients with metastatic breast cancer, docetaxel provided superior survival compared with paclitaxel. Each additional month of survival had an incremental cost of $2434.

Key words: breast neoplasms, docetaxel, paclitaxel, taxoids, treatment outcome

Received for publication August 23, 2007. Accepted for publication October 11, 2007.


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