Clinical Outcomes of Women with Metastatic Breast Cancer Treated with Nab-Paclitaxel: Experience from a Single Academic Cancer Centre

Dent, Susan; Fraser, Judith; Graham, Nadine; Campbell, Michelle M; Hopkins, Sean; Dranitsaris, George

doi:10.3747/co.20.1202

Cited by 14 publications

(18 citation statements)

References 18 publications

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“…The activity of q3w nab-paclitaxel observed in our study was higher than that previously reported in taxane-pretreated MBC patients, 31 , 36 , 37 but a cross-comparison of results is difficult because of the different characteristics of enrolled patients. We reported an ORR of 48%, including 13% complete responses, in 52 evaluable patients; 13 out of 24 women (54%) previously given paclitaxel/bevacizumab or docetaxel/capecitabine as a first-line treatment for the metastatic disease demonstrated an objective response.…”

Section: Discussioncontrasting

confidence: 92%

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Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) as second-line chemotherapy in HER2-negative, taxane-pretreated metastatic breast cancer patients: prospective evaluation of activity, safety, and quality of life

Palumbo¹,

Sottotetti²,

Trifirò³

et al. 2015

DDDT

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BackgroundA prospective, multicenter trial was undertaken to assess the activity, safety, and quality of life of nanoparticle albumin-bound paclitaxel (nab-paclitaxel) as second-line chemotherapy in HER2-negative, taxane-pretreated metastatic breast cancer (MBC).Patients and methodsFifty-two women with HER2-negative MBC who were candidates for second-line chemotherapy for the metastatic disease were enrolled and treated at three centers in Northern Italy. All patients had previously received taxane-based chemotherapy in the adjuvant or first-line metastatic setting. Single-agent nab-paclitaxel was given at the dose of 260 mg/m2 as a 30-minute intravenous infusion on day 1 each treatment cycle, which lasted 3 weeks, in the outpatient setting. No steroid or antihistamine premedication was provided. Treatment was stopped for documented disease progression, unacceptable toxicity, or patient refusal.ResultsAll of the enrolled patients were evaluable for the study endpoints. The objective response rate was 48% (95% CI, 31.5%–61.3%) and included complete responses from 13.5%. Disease stabilization was obtained in 19 patients and lasted >6 months in 15 of them; the overall clinical benefit rate was 77%. The median time to response was 70 days (range 52–86 days). The median progression-free survival time was 8.9 months (95% CI, 8.0–11.6 months, range 5–21+ months). The median overall survival point has not yet been reached. Toxicities were expected and manageable with good patient compliance and preserved quality of life in patients given long-term treatment.ConclusionOur results showed that single-agent nab-paclitaxel 260 mg/m2 every 3 weeks is an effective and well tolerated regimen as second-line chemotherapy in HER2-negative, taxane-pretreated MBC patients, and that it produced interesting values of objective response rate and progression-free survival without the concern of significant toxicity. Specifically, the present study shows that such a regimen is a valid therapeutic option for that ‘difficult to treat’ patient population represented by women who at the time of disease relapse have already received the most active agents in the adjuvant and/or metastatic setting (ie, conventional taxanes).

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Section: Discussioncontrasting

confidence: 92%

“… 32 – 35 To date, little information is available regarding the approved q3w schedule in the real life clinical context, because most of the data have been provided by post hoc or retrospective analyses. 36 – 38 Finally, the impact of such a treatment option on patient QoL has not been specifically evaluated in this setting.…”

Section: Introductionmentioning

confidence: 99%

Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) as second-line chemotherapy in HER2-negative, taxane-pretreated metastatic breast cancer patients: prospective evaluation of activity, safety, and quality of life

Palumbo¹,

Sottotetti²,

Trifirò³

et al. 2015

DDDT

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“…Details are provided regarding sensitive neuropathy, the most common adverse event, which occurred in 41.9% of the treated patients (all grades), while grade 3 neuropathy was observed in 11.6% of cases. Regardless of the schedule of administration, women who experienced clinical benefit lived significantly longer than those who did not achieve it (17.3 versus 7.7 months, p < 0.001) [Dent et al 2013]. A subsequent study enrolled 138 MBC patients across five cancer centres in British Columbia from 2007 to 2011.…”

Section: Clinical Development Of Nab-paclitaxel In Breast Cancer Patimentioning

confidence: 99%

Targeted chemotherapy with nanoparticle albumin-bound paclitaxel (nab-paclitaxel) in metastatic breast cancer: which benefit for which patients?

2016

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Abstract:The therapeutic goals in metastatic breast cancer (MBC) remain palliative in nature, aimed at controlling symptoms, improving or maintaining quality of life and prolonging survival. The advent of new drugs and new formulations of standard agents has led to better outcomes in patients with advanced or metastatic disease. These developments have also allowed a tailored therapeutic approach, in which the molecular biology of the tumour, the treatment history, and patient attitudes are taken into account in the decision-making process. Targeting drug delivery to the tumour is a promising mean of increasing the therapeutic index of highly active agents such as the taxanes, and nanoparticle albuminbound paclitaxel (nab-paclitaxel), the first nanotechnology-based drug developed in cancer treatment, is one such advance. Data from randomized trials support the efficacy of singleagent nab-paclitaxel as first-line and further treatment lines in MBC at the registered 3-weekly schedule of 260 mg/m 2 , but emerging evidence suggests its activity as a weekly regimen or combined with other agents in various clinical scenarios. Thus, nab-paclitaxel seems to offer flexibility in terms of dosing schedules, allowing physicians to tailor the dose according to different clinical situations. This paper reviews the clinical trial background for nab-paclitaxel in MBC, focusing on specific 'difficult-to-treat' patient populations, such as taxane-pretreated or elderly women, as well as those with triple-negative, HER2-positive and poor-prognosticfactors disease. Moving beyond evidence-based information, 'real life' available experiences are also discussed with the aim of providing an update for daily clinical practice.

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“…Nab-paclitaxel (Abraxane ® , Celgene) was given at a dose of 150 mg/m 2 on days 1, 8 and 15 of each chemotherapy cycle (28-day cycles) until disease progression. This dose was derived from previous studies of metastatic breast cancer [ 15 , 16 ]. Treatment was administered until disease progression and dose-adjustment criteria were based on hematological parameters.…”

Section: Methodsmentioning

confidence: 99%

Nab-paclitaxel as second-line treatment in advanced gastric cancer: a multicenter phase II study of the Hellenic Oncology Research Group

Katsaounis

Κotsakis²,

Kentepozidis

et al. 2017

aog

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Background:This study evaluated the safety and efficacy of nab-paclitaxel as second-line treatment in patients with advanced gastric adenocarcinoma.Methods:Thirty-nine pretreated patients [33 with taxane-based regimens (docetaxel, cisplatin, and fluorouracil)] and 6 with combination of fluoropyrimidines plus cisplatin with locally advanced inoperable and metastatic gastric and gastroesophageal junction adenocarcinoma were treated with weekly nab-paclitaxel (150 mg/m2 d1, d8, d15 in cycles of 28 days).Results:Partial response (PR) was documented in nine patients (23.1%; 95% confidence interval 10.1-37.2%), stable disease (SD) in 11 (28.2%) and disease progression in 18 (46.2%). The disease control rate (SD + PR + complete response) was 51.3%. Grade 3 and 4 neutropenia occurred in 10.2% and 5.1% of patients, respectively; grade 3 anemia in 5.1%; grade 3 neurotoxicity in 5.1%; and grade 2 pain in 5.1%. The median progression-free survival was 3.0 months (range 0.3-13.6) and the median overall survival 6.8 months (range 0.3-22).Conclusion:Nab-paclitaxel as second-line treatment in locally advanced inoperable or metastatic gastric and gastroesophageal junction carcinoma is an active chemotherapy regimen with a manageable toxicity profile and merits further evaluation.

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Clinical Outcomes of Women with Metastatic Breast Cancer Treated with Nab-Paclitaxel: Experience from a Single Academic Cancer Centre

Cited by 14 publications

References 18 publications

Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) as second-line chemotherapy in HER2-negative, taxane-pretreated metastatic breast cancer patients: prospective evaluation of activity, safety, and quality of life

Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) as second-line chemotherapy in HER2-negative, taxane-pretreated metastatic breast cancer patients: prospective evaluation of activity, safety, and quality of life

Targeted chemotherapy with nanoparticle albumin-bound paclitaxel (nab-paclitaxel) in metastatic breast cancer: which benefit for which patients?

Nab-paclitaxel as second-line treatment in advanced gastric cancer: a multicenter phase II study of the Hellenic Oncology Research Group

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