Primary docetaxel chemotherapy in patients with breast cancer: impact on response and survival.

Primary chemotherapy achieves high clinical response rates and facilitates breast conservation in many patients with large and locally advanced breast cancer. It may also serve to indicate responsiveness to chemotherapeutic agents. A pathological complete response to primary chemotherapy is a primary predictor and surrogate marker of long-term outcome, but occurs in only approximately 15% of patients. Docetaxel is of particular interest in this setting. Primary docetaxel chemotherapy has single-agent activity in both dose-dense and traditional schedules, with acceptable tolerability. Furthermore, concomitant docetaxel–anthracycline schedules have shown promise in Phase II trials, achieving clinical overall response rates (ORRs) of 77–96%, pathological complete responses of up to 24%, and breast conservation in up to 89% of patients.