Abstract
BackgroundNanoparticle albumin-bound paclitaxel (nab-paclitaxel) as neoadjuvant chemotherapy (NAC) for breast cancer remains controversial. We conducted a retrospective study to compare the efficacy and safety of nab-paclitaxel with those of docetaxel as neoadjuvant regimens for HER2-negative breast cancer.MethodsIn this retrospective analysis, a total of 159 HER2-negative breast cancer patients who had undergone operation after NAC were consecutively analyzed from May 2016 to April 2018. Patients were classified into the nab-paclitaxel group (n = 79, nab-paclitaxel 260 mg/m2, epirubicin 75 mg/m2, and cyclophosphamide 500 mg/m2) and the docetaxel group (n = 80, docetaxel 75 mg/m2, epirubicin 75 mg/m2, and cyclophosphamide 500 mg/m2) according to the drug they received for neoadjuvant treatment. The efficacy and adverse events were evaluated in the two groups.ResultsThe pathological complete response (pCR)(ypT0/isN0) rate was significantly higher in the nab-paclitaxel group than in the docetaxel group (36.71% vs 20.00%; P = 0.031). The multivariate analysis revealed that therapeutic drugs, lymph node status, and tumor subtype were the most significant factor influencing treatment outcome. At a median follow-up of 47 months, disease-free survival (DFS) was not significantly different in those assigned to nab-paclitaxel compared with docetaxel (82.28% vs 76.25%; P = 0.331). The incidence of peripheral sensory neuropathy in the nab-paclitaxel group was higher than that in the docetaxel group (60.76% vs 36.25%; P = 0.008), while the incidence of arthralgia was observed more frequently in the docetaxel group (57.50% vs 39.97%; P = 0.047).ConclusionsCompared with docetaxel, nab-paclitaxel achieved a higher pCR rate, especially those patients with triple-negative breast cancer or lymph node negative breast cancer. However, there was no significant difference in DFS between the two groups. This study provides a valuable reference for the management of patients with HER2-negative breast cancer.
Highlights
Neoadjuvant chemotherapy (NAC) has become a treatment option for patients with operable breast cancer [1]
Another study reported that higher PCR rates were achieved by the nab-paclitaxel group compared with the Abbreviations: nab-paclitaxel, nanoparticle albumin-bound paclitaxel; pCR, pathological complete response; DFS, disease-free survival; NAC, neoadjuvant chemotherapy; ER, estrogen receptor; PR, progesterone receptor; HER2, human epidermal growth factor receptor 2; PR, partial response; PD, progressive disease; SD, stable disease; TNBC, triple-negative breast cancer; IHC, immunohistochemistry; HR, hazard ratio; taxane–epirubicin– cyclophosphamide (TEC), taxane–epirubicin–cyclophosphamide; CIs, confidence intervals
The present results showed that TNBC patients achieved significantly better pCR rates with nab-paclitaxel than with docetaxel
Summary
Neoadjuvant chemotherapy (NAC) has become a treatment option for patients with operable breast cancer [1]. Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) is a unique non-solvent-containing protein formulation. It can obviate the need for prophylactic anti-histamine and steroid treatment because of its much lower risk of hypersensitivity compared with conventional paclitaxel, it is prone to causing peripheral neuropathy [7]. Another study reported that higher PCR rates were achieved by the nab-paclitaxel group compared with the Abbreviations: nab-paclitaxel, nanoparticle albumin-bound paclitaxel; pCR, pathological complete response; DFS, disease-free survival; NAC, neoadjuvant chemotherapy; ER, estrogen receptor; PR, progesterone receptor; HER2, human epidermal growth factor receptor 2; PR, partial response; PD, progressive disease; SD, stable disease; TNBC, triple-negative breast cancer; IHC, immunohistochemistry; HR, hazard ratio; TEC, taxane–epirubicin–cyclophosphamide; CIs, confidence intervals. We conducted a retrospective study to compare the efficacy and safety of nab-paclitaxel with those of docetaxel as neoadjuvant regimens for HER2-negative breast cancer
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