New Perspectives in Breast Cancer:
The Growing Role of Taxanes
in the Adjuvant Setting

NEEDS STATEMENT
Each year, more than 200,000 women in the United States undergo treatment for breast cancer. While disease management had largely focused on aggressive local surgery, current strategies are emphasizing earlier systemic treatment. In the early 1990s, the taxanes were established as active agents in metastatic breast cancer, and their role in this area is evolving. This activity reviews data from the most mature trials of taxanes in adjuvant chemotherapy.

TARGET AUDIENCE
This educational activity is intended for physicians, pharmacists, and nurses involved in the management of patients with cancer.

LEARNING OBJECTIVES
At the completion of this activity, participants should be able to:

• Review use of taxanes in adjuvant setting
  
• Discuss data from recent trials of dose-dense chemotherapy with taxanes
  
• Describe controversies associated with dose-dense chemotherapy
  
• Summarize the role of adjuvant chemotherapy with taxanes in patients with breast cancer

ACCREDITATION AND CREDIT DESIGNATION
Accreditation—Physician
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the Dannemiller Memorial Educational Foundation and the McMahon Publishing Group. The Dannemiller Memorial Educational Foundation is accredited by the ACCME to provide continuing medical education for physicians.

Designation of Credit—Physicians
The Dannemiller Memorial Educational Foundation designates this educational activity for a maximum of 1 category 1 credit toward the American Medical Association Physician’s Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.

Accreditation/Designation of Credit—Nurses
The Dannemiller Memorial Educational Foundation is an approved provider of the California Board of Registered Nursing. Provider approved by the California Board of Registered Nursing, Provider Number 4229, for 1 contact hour.

	Purdue University is accredited by the American Council on Pharmaceutical Education as a provider of continuing pharmaceutical education. This is a continuing education activity of Purdue, an equal access/equal opportunity university. To receive the 1 contact hour of continuing education credit, pharmacists should complete the activity requirements and evaluation at the conclusion of the monograph. Approval is valid from the initial release date of October 23, 2003. The expiration date is October 31, 2004. Program Number 018-999-03-107-H01.

METHOD OF PARTICIPATION
This activity should take approximately 1 hour to complete. The participant should, in order, read the objectives, read the article, answer the 10-question multiple-choice post-test, and complete the evaluation. The evaluation form provides each participant with the opportunity to comment on the quality of the instructional process, the perception of enhanced professional effectiveness, the perception of commercial bias, and his or her views on future educational needs. To receive credit for this activity, follow the instructions provided on the answer sheet. This credit will be valid through October 31, 2004. No credit will be given after this date.

For questions regarding the content of this activity, contact Dannemiller Memorial Educational Foundation, accredited provider for this CME/CE activity, at ralphg@pain.com. For technical assistance, please contact support@cecity.com.

CLINICAL EDITOR
Elizabeth Tan-Chiu, MD
Director, Early Stage Breast Cancer Program
Cancer Research Network Inc.
Plantation, Florida

CO-EDITOR
Charles Vogel, MD, FACP
Clinical Professor
Sylvester Comprehensive Cancer Center
University of Miami School of Medicine
Miami, Florida

WRITTEN BY
Joshua F. Kilbridge

DISCLOSURE INFORMATION
It is the policy of the Dannemiller Memorial Educational Foundation that faculty participating in a continuing medical education activity disclose to participants any significant financial interest or other relationship (1) with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation, and (2) with any commercial supporters of the activity.

Dr. Tan-Chiu reports no such relationships. Dr. Vogel discloses that he serves on the speakers bureaus of Amgen, AstraZeneca, Aventis, Biomira, Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Genentech, GlaxoSmithKline, Novartis, Ortho Biotech, Pfizer, Pierre Fabre, and Roche; he is a consultant for AstraZeneca, Aventis, BCIRG, Biomira, Bristol-Myers Squibb, Genentech, GlaxoSmithKline, Ortho Biotech, and Pfizer; and he has received research support from Amgen, Aventis, BCIRG, Biomira, Bristol-Myers Squibb, Celgene, Genentech, GlaxoSmithKline, Novartis, NSABP, Ortho Biotech, Pfizer, and Roche.

This monograph was drafted by Joshua F. Kilbridge, who has no relationships to disclose. The content of this activity was controlled and approved by the faculty.

DISCLOSURE OF UNLABELED USE
This educational activity contains discussion of published and/or investigational uses of cyclophosphamide, docetaxel, doxorubicin, fluorouracil, paclitaxel, and tamoxifen; some uses of these agents have not been approved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

SOFTWARE REQUIREMENTS
Internet Explorer (v5.5 or greater) or Netscape (v7.02 or greater)
Adobe Acrobat Reader
Windows 98, SE or above; OR Mac OS 10.2; 800 x 600 minimum monitor resolution (1024 x 768 recommended)

Jointly sponsored by the Dannemiller Memorial Educational Foundation and the McMahon Publishing Group.
Sponsored for pharmacists by Purdue University.

To access the Dannemiller site please click on the logo.

This activity is supported through an unrestricted educational grant from Aventis Pharmaceuticals.

Pharmacists Click Here

Physicians Licensed in the U.S. Click Here

Physicians Not Licensed in the U.S. and all Others Click Here