Substituting Nab-paclitaxel for Paclitaxel in Invasive Breast Cancer
A significantly higher pathologic complete response rate was seen in patients with early breast cancer who received neoadjuvant nab-paclitaxel instead of paclitaxel as part of an anthracycline/taxane-based sequential chemotherapy regimen, with a pronounced improvement in patients with triple-negative breast cancer. These findings were from the prospectively randomized phase III GeparSepto trial, presented by Andreas Schneeweiss, MD, Professor of Medicine at the University of Heidelberg, Germany, and colleagues, at the 2017 San Antonio Breast Cancer Symposium (Abstract GS3-05).
The GeparSepto study showed that substituting paclitaxel with nab-paclitaxel, followed by epirubicin/cyclophosphamide as neoadjuvant chemotherapy, significantly increased the rate of pathologic complete response from 29% to 38% in previously untreated patients with unilateral or bilateral primary invasive breast cancer. However, according to the investigators, whether this effect will translate into a survival benefit is still unknown.
The trial randomized 1229 patients from 69 German centers between July 2012 and December 2013. Patients received either nab-paclitaxel or paclitaxel for 12 weeks followed by 4 cycles of conventionally dosed epirubicin/cyclophosphamide. The primary objective is pathologic complete response, and follow-up is still ongoing.
“The expected long-term results will help to assess the overall benefit of nab-paclitaxel in breast cancer and the surrogate value of pathological complete response for survival endpoints,” the investigators reported.