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Recommendations for use of Taxane-containing chemotherapy regimens

Clinical practice recommendations

Recommendations to individuals should be based on their risks without taxane-containing chemotherapy regimens, the absolute benefits and harms of treatment, and their preference. These factors should be discussed with the woman. Women receiving a taxane-containing regimen should be reviewed regularly and monitored for adverse effects by clinicians familiar with the drug

RECOMMENDATIONS LEVEL OF EVIDENCE24 REFERENCE
Adjuvant chemotherapy for women with early (operable) breast cancer:
A taxane-containing regimen should be considered for women at intermediate-to-high risk of breast cancer recurrence I Cochrane2
The risks and benefits of using a taxane-containing regimen should be discussed with the woman, taking into consideration her individual risk profile and co-morbidities I NBCC* & NCCI25
Optimal schedule of administration

The optimal scheduling and dosing of taxanes in adjuvant chemotherapy regimens for survival benefits is unknown

Decisions on scheduling and dosing of taxane-containing regimens should be based on factors other than survival outcomes, and take into consideration the woman’s individual risk profile and co-morbidities— consideration of toxicity effects should guide dosing and scheduling decisions

Hormone receptor status
Taxane-containing regimens should be considered as an option regardless of tumour hormone-receptor status I Cochrane2
Adverse events

Women should be informed of the increased risk of febrile neutropenia associated with taxane-containing regimens

For women at significant risk of febrile neutropenia, primary prophylaxis with growth factor support should be considered

Women should be informed of the potential adverse effects of a taxane-containing regimen and any uncertainties about long-term effects I Cochrane2
Women unsuitable for anthracycline
If a woman is not suitable to receive an anthracycline-containing regimen, a taxane-containing non-anthracycline regimen can be considered II Jones5

* In February 2008, National Breast Cancer Centre (NBCC), incorporating the Ovarian Cancer Program, changed its name to National Breast and Ovarian Cancer Centre (NBOCC). In July 2011, NBOCC amalgamated with Cancer Australia to form a single national agency, Cancer Australia, to provide leadership in cancer control and improve outcomes for Australians affected by cancer.

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