Search for Optimal Dose of Nab-paclitaxel for Older Patients With Advanced Breast Cancer
Posted: Monday, October 5, 2020
There are limited data available regarding the safety and efficacy of treatment with nanoparticle albumin-bound paclitaxel (nab-paclitaxel) in older patients with advanced breast cancer. As a result, Giuseppe Mottino, MD, of AUSL Toscana Centro, Prato, Italy, and colleagues conducted a study to identify the optimal weekly dose of nab-paclitaxel for this population. The results of the multicenter phase II EFFECT trial were published in Breast Cancer Research.
“Weekly taxanes are a suitable treatment option for older patients with metastatic breast cancer,” the investigators commented. “Whilst solvent-based paclitaxel and solvent-based docetaxel are established options, the EFFECT trial has evaluated [the] role of weekly nab-paclitaxel in this selected population, identifying 100 mg/m2 on days 1, 8, and 15 on a 28-day cycle as an effective and well-tolerated dose.”
The study included a total of 160 patients with advanced breast cancer. To be enrolled, the patients must have been at least 65 years of age. In a 1:1 allocation ratio, they were randomly assigned to receive either 100 mg/m2 (arm A) or 125 mg/m2 (arm B) of first-line weekly nab-paclitaxel. Follow-up data were provided for a median of 32.6 months.
A total of 140 events were reported in 158 evaluable patients. The median event-free survival times in arms A and B were 8.2 (P = .188) and 8.3 (P = .078) months, respectively. Similar progression-free survival, overall survival, and response rates were observed in both groups. Patients in arm A experienced lower rates of dose reduction (39% vs. 58%) and treatment discontinuation due to adverse events (14% vs. 28%) than those in arm B. Grade 2 to 3 fatigue (arm A vs. B, 43% vs. 51%, respectively) and peripheral neuropathy (arm A vs. B, 19% vs. 38%, respectively) were among the most commonly reported nonhematologic adverse events.
Disclosure: For full disclosures of the study authors, visit biomedcentral.com.