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  Vol. 294 No. 17, November 2, 2005 TABLE OF CONTENTS
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Life-threatening Complications From Doxorubicin-Docetaxel Chemotherapy for Breast Cancer—Reply

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In Reply: Our understanding is that two trials using docetaxel in the adjuvant setting (National Surgical Adjuvant Breast and Bowel Project [NSABP] B-301 and GEICAM 98052) were amended in 2000 by adding prophylactic G-CSF to the groups combining doxorubicin with docetaxel (either alone or with cyclophosphamide) after interim analyses had shown rates of febrile neutropenia above 20%. Had we been given this information when we interrupted the RAPP-01 trial in 2001 after 2 serious adverse events including 1 death, we would not have reopened it without such preventive measures. The gastrointestinal symptoms focused our attention on colitis. No data were available in the literature at that time to justify systematic addition of G-CSF to the docetaxel-doxorubicin combination. Following the addition of prophylactic G-CSF in the GEICAM trial, the rate of febrile neutropenia associated with the docetaxel-doxorubicin-cyclophosphamide regimen fell below 10%.2

The controversial use of prophylactic antibiotics, favoring the emergence . . . [Full Text of this Article]

Etienne G. C. Brain, MD
e.brain@stcloud-huguenin.org
René Huguenin Cancer Centre
Department of Medical Oncology
Saint-Cloud, France

Thomas Bachelot, MD
Léon Bérard Cancer Centre
Department of Medical Oncology
Lyon, France

Daniel Serin, MD
Sainte Catherine Institute Breast Clinic
Avignon, France
for the RAPP-01 Trial Investigators



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RELATED ARTICLES

Life-threatening Complications From Doxorubicin-Docetaxel Chemotherapy for Breast Cancer
Miguel Martin, Charles Vogel, John Crown, and John Mackey
JAMA. 2005;294(17):2166.
EXTRACT | FULL TEXT  

Life-Threatening Sepsis Associated With Adjuvant Doxorubicin Plus Docetaxel for Intermediate-Risk Breast Cancer
Etienne G. C. Brain, Thomas Bachelot, Daniel Serin, Sylvie Kirscher, Yvon Graic, Jean-Christophe Eymard, Jean-Marc Extra, Martin Combe, Emmanuelle Fourme, Catherine Noguès, Jacques Rouëssé, and for the RAPP-01 Trial Investigators
JAMA. 2005;293(19):2367-2371.
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