Current status of taxanes as adjuvant therapy for early-stage breast cancer.

Several factors explain the significant improvement in outcome among patients diagnosed with breast cancer over the last 20 years. Chief among them are the greater adoption of screening strategies and an improved understanding of the benefit offered by adjuvant systemic therapy in reducing the risk of cancer recurrence and death. Predictive markers of response like the estrogen receptor (ER) and the human epidermal growth factor receptor 2 (HER2) help identify those most likely to derive a survival benefit from adjuvant therapy with anti-estrogens and trastuzumab therapy, respectively. However, despite the lack of robust predictive markers of clinical benefit, adjuvant systemic chemotherapy is an effective tool to improve the survival odds of breast cancer patients, especially those with ER-negative breast cancer. The Oxford Overview confirmed the incremental benefit offered by the use of anthracycline-containing regimens in the adjuvant setting. After being approved in the early 1990's for the treatment of advanced breast cancer, the taxanes gradually established themselves as useful drugs in the adjuvant setting. In this commentary, we review much of the current data that support the use of taxanes in early-stage breast cancer.