Oncology Department Unit, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy.
Oncology Unit, ASST degli Spedali Civili di Brescia, Brescia, Italy.
Clin Breast Cancer. 2017 Oct;17(6):433-440. doi: 10.1016/j.clbc.2017.03.004. Epub 2017 Mar 9.
Few data are available regarding efficacy and safety of nanoparticle albumin-bound (nab)-paclitaxel in advanced breast cancer patients outside a controlled trial, especially for the weekly schedule.
We prospectively collected data of advanced breast cancer patients who were candidates to be treated with weekly (125 mg/m for 3 consecutive weeks followed by a 1-week rest) or every 3 weeks (260 mg/m) schedules of nab-paclitaxel, according to physician's decision.
The study enrolled 209 patients, of whom 92 (39.3%) received weekly nab-paclitaxel. The median age was 58 (range, 31-84) years; 21.8% of the patients were classified as triple-negative breast cancer (estrogen-recetor/progesteron-receptor-negative). The median number of cycles was 5.5. The overall response rate was 32.1% in the whole population, without any significant difference according to schedule, previous paclitaxel exposure, presence of visceral metastases, or line of treatment. The median time to disease progression was 6 months (95% confidence interval, 1-34), with no differences according to the schedule of treatment. Severe adverse events (Grade 3-4) were observed in 60.6% of the patients. The main toxicities were alopecia (53.4%), neutropenia (3%), and sensory neuropathy (2.1%).
Our real-life data indicate that both schedules of nab-paclitaxel are manageable and safe in advanced breast cancer patients, even if previously treated with other taxanes.
在临床试验之外,关于纳米白蛋白结合紫杉醇(nab-紫杉醇)在晚期乳腺癌患者中的疗效和安全性的数据很少,特别是对于每周方案。
我们前瞻性地收集了符合条件的晚期乳腺癌患者的数据,这些患者候选治疗方案为每周(连续 3 周给予 125 mg/m,然后休息 1 周)或每 3 周(260 mg/m)给予 nab-紫杉醇的方案,具体方案由医生决定。
该研究纳入了 209 名患者,其中 92 名(39.3%)接受了每周 nab-紫杉醇治疗。中位年龄为 58 岁(范围 31-84 岁);21.8%的患者被归类为三阴性乳腺癌(雌激素受体/孕激素受体阴性)。中位治疗周期数为 5.5 个。整个患者群体的总缓解率为 32.1%,根据方案、先前紫杉醇暴露、是否存在内脏转移或治疗线,无显著差异。疾病进展的中位时间为 6 个月(95%置信区间,1-34),与治疗方案无关。60.6%的患者发生严重不良事件(3-4 级)。主要毒性包括脱发(53.4%)、中性粒细胞减少(3%)和感觉神经病变(2.1%)。
我们的真实数据表明,nab-紫杉醇的两种方案在晚期乳腺癌患者中均具有良好的可管理性和安全性,即使患者之前曾接受过其他紫杉烷类药物治疗。