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To the Editor: In their study of life-threatening sepsis associated with use of docetaxel plus doxorubicin as adjuvant chemotherapy, Dr Brain and colleagues¹ reported 3 cases of febrile neutropenia and severe gastrointestinal toxicity (2 of which were fatal) among 311 patients who were treated with the combination of docetaxel and doxorubicin as postoperative adjuvant therapy for breast cancer. This 0.63% incidence of treatment-related mortality contrasts with our experience, which includes more than 2900 patients treated with docetaxel-doxorubicin combinations in GEICAM 9805,² BCIRG 001,³ and BCIRG 005. The incidence of treatment-related death from any cause in these trials does not exceed 0.2% (95% confidence interval, 0.19%-0.21%). A similar low rate of treatment-related death with docetaxel-doxorubicin was reported in ECOG 2197.⁴ The incidence of febrile neutropenia reported by Brain et al (40.8%) is also higher than that reported in these other trials (around 25%) and in a recently published study with exactly . . . [Full Text of this Article]

Miguel Martin, MD
mmartin@geicam.org
Hospital Universitario San Carlos
Madrid, Spain

Charles Vogel, MD
Cancer Research Network
Plantation, Fla

John Crown, MD
St Vincent’s University Hospital
Dublin, Ireland

John Mackey, MD
Cross Cancer Institute
Edmonton, Alberta
for the BCIRG (Breast Cancer International Research Group)

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