Significantly Longer Progression-Free Survival With <i>nab</i>-Paclitaxel Compared With Docetaxel As First-Line Therapy for Metastatic Breast Cancer

Gradishar, William J.; Krasnojon, D.; Cheporov, Sergey; Махсон, А. Н.; Manikhas, G.; Clawson, Alicia; Bhar, Paul

doi:10.1200/jco.2008.18.5397

Cited by 322 publications

(297 citation statements)

References 23 publications

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“…This may be related to lower relative dose intensity of nab-paclitaxel administered at our institution. Based on previously reported data, nab-paclitaxel is thought to contribute more to the high rates of neutropenia in this regimen, whereas gemcitabine more likely contributes to thrombocytopenia (von Hoff et al, 2013;Gradishar et al, 2009;Coleman et al, 2011;Burris III et al, 1997). Our study findings support this hypothesis, as gemcitabine dose density and intensity were high at 96% and 72% respectively, and the incidence of grade ≥3 thrombocytopenia, though not significantly different, appeared to trend higher than what was observed in the MPACT trial.…”

Section: Discussionsupporting

confidence: 80%

Real-World Evaluation of Hematologic Toxicity Associated with nab-Paclitaxel Plus Gemcitabine for Advanced Pancreatic Cancer

Lynch¹,

Sen²,

Ward³

et al. 2015

AJCRCO

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Albumin-bound paclitaxel (nab-paclitaxel), in combination with gemcitabine, is used for first-or second-line treatment of advanced pancreatic cancer (APC). The objectives of this retrospective single institution study are to report the rates of hematologic toxicity, febrile neutropenia (FN), growth factor utilization, progression-free and overall survival of nab-paclitaxel-gemcitabine in a real-world, non-clinical trial setting. Patients with APC treated with nab-paclitaxel-gemcitabine between January 1, 2012 and December 31, 2014 were identified. Data were retrospectively collected from the electronic medical record under an institutional IRB-approved protocol. A total of 29 patients treated with nab-paclitaxel-gemcitabine were included in the analyses. Half of the patients (52%) had received previous therapy for advanced disease, with the majority of those patients (80%) receiving FOLFIRINOX. Grade ≥3 neutropenia and thrombocytopenia were reported in 31% and 21% of patients. FN was observed in 1 patient (3%), and growth factor was utilized in 10% of patients. Most patients (86%) required at least one dose modification, with 76% of patients having dose omission due to toxicity. Median progression-free survival was 3.9 months and median overall survival was 5.4 months. Our results suggest that the rates of hematologic toxicity in the real-world setting are similar to those seen in clinical trial population, despite variances in clinical practice. It remains unclear whether the underutilization of growth factor support affects the incidence of neutropenia outside of clinical trials. The short overall and progression-free survival observed in this study population are not unexpected, as the majority of patients received nab-paclitaxel-gemcitabine as second-line therapy.

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Section: Discussionsupporting

confidence: 80%

Real-World Evaluation of Hematologic Toxicity Associated with nab-Paclitaxel Plus Gemcitabine for Advanced Pancreatic Cancer

Lynch¹,

Sen²,

Ward³

et al. 2015

AJCRCO

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“…The results of a randomized phase ii study in women with mbc suggest that weekly dosing of nab-paclitaxel (qw: 100 mg/ m 2 , 150 mg/m 2 ) is feasible and may offer clinical benefit compared with q3w nab-paclitaxel (300 mg/ m 2 ) and docetaxel (100 mg/m 2 ) 6 . Although grade 3 sensory neuropathy was observed more frequently with nab-paclitaxel (300 mg/m 2 q3w, 2%; 100 mg/m 2 qw, 9%; 150 mg/m 2 qw, 22%), the time to onset was significantly longer than that reported in trials with paclitaxel (151-189 days depending on schedule vs. within 1-3 days and peaking around 27 days) [7][8][9] .…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2013

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ConclusionsOur clinical experience demonstrates that most women treated with nab-paclitaxel experienced some clinical benefit. Patients achieving clinical benefit lived significantly longer than those who did not. Nab-paclitaxel was well tolerated, with the primary toxicity being mild sensory neuropathy. Nabpaclitaxel represents another treatment option, with a favourable toxicity profile, for women with mbc.

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“…Tri-weekly treatment with nanoparticle albumin-bound paclitaxel (nab-paclitaxel) resulted in significantly higher response rates and a favorable safety profile compared with standard paclitaxel for MBC patients in another phase III study (4). In addition, tri-weekly nab-paclitaxel as first-line therapy for MBC achieved similar response rates compared with tri-weekly docetaxel (100 mg/m 2 ) in the phase II study (5).…”

Section: Introductionmentioning

confidence: 83%

Phase I study of nanoparticle albumin-bound paclitaxel, carboplatin and trastuzumab in women with human epidermal growth factor receptor 2-overexpressing breast cancer

Tezuka

Takashima

Kashiwagi

et al. 2017

Molecular and Clinical Oncology

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Abstract. Although the concurrent use of anthracycline-containing chemotherapy and taxane with trastuzumab are considered the treatment of choice for the primary systemic therapy of human epidermal growth factor receptor 2 (HER2)-overexpressing early breast cancer, non-anthracycline regimens, such as concurrent administration of docetaxel and carboplatin with trastuzumab, exhibited similar efficacies in a previous study. In addition, tri-weekly treatment with nanoparticle albumin-bound paclitaxel (nab-paclitaxel) resulted in significantly higher response rates and a favorable safety profile compared with standard paclitaxel for metastatic breast cancer patients in another phase III study. Based on these results, a phase I study of combination therapy with nab-paclitaxel, carboplatin and trastuzumab was planned, in order to estimate its efficacy and safety for HER2-overexpressing locally advanced breast cancer. The present study was designed to determine the dose-limiting toxicity (DLT), maximum tolerated dose and recommended dose of this combination treatment in women with HER2-overexpressing locally advanced breast cancer. The starting dose of nab-paclitaxel was 220 mg/m 2 (level 1), and the dose was escalated to 260 mg/m 2 (level 2). Nab-paclitaxel was administered with carboplatin (area under the curve, 6 mg/ml/min) and trastuzumab tri-weekly. A total of 6 patients were enrolled. Although no DLT was observed during the first cycle, 4 patients developed grade 4 thrombocytopenia, 2 had grade 4 neutropenia and 3 exhibited a grade 4 decrease in hemoglobin levels. In the present phase I study, although no patients experienced DLTs, this regimen was associated with severe hematological toxicities and it was not well tolerated. However, considering the high efficacy and lower risk of cardiotoxicity and secondary carcinogenesis with taxane, platinum and trastuzumab combination therapy, further evaluation of another regimen including weekly administration or a more accurate dose setting should be conducted.Phase I study of nanoparticle albumin-bound paclitaxel, carboplatin and trastuzumab in women with human epidermal growth factor receptor 2-overexpressing breast cancer

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Significantly Longer Progression-Free Survival With nab-Paclitaxel Compared With Docetaxel As First-Line Therapy for Metastatic Breast Cancer

Cited by 322 publications

References 23 publications

Real-World Evaluation of Hematologic Toxicity Associated with nab-Paclitaxel Plus Gemcitabine for Advanced Pancreatic Cancer

Real-World Evaluation of Hematologic Toxicity Associated with nab-Paclitaxel Plus Gemcitabine for Advanced Pancreatic Cancer

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

Phase I study of nanoparticle albumin-bound paclitaxel, carboplatin and trastuzumab in women with human epidermal growth factor receptor 2-overexpressing breast cancer

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