Experience of weekly paclitaxel therapy in patients with metastatic breast cancer at a single cancer institution

Abstract

855 Background: Paclitaxel is an active agent for the treatment of metastatic breast cancer (MBC) and is commonly administered on a three weekly schedule. However, this regimen is associated with toxicity, in particular, neuropathy and myelotoxicity, which can make it difficult for patients of poorer performance to tolerate. There are emerging data indicating that weekly administration is both better tolerated and may be more efficacious. Methods: We performed a retrospective case note review of all patients with MBC treated weekly paclitaxel (WP) at a single institution, the Christie Hospital, Manchester, from November 2001 to June 2004. Results: 43 patients with MBC received WP; 32 receiving WP alone and 11 patients also received concurrent trastuzumab (WP+T). WP was given as first line therapy for MBC in 58% patients. The median age of the patients receiving WP alone was 59.5yrs; 53% with WHO PS 2–4. Those also receiving WP+T were younger (median age 52yrs) with better PS (18% PS 2–4). Patients on WP alone received a median of 10 weeks treatment; those receiving WP+T received a median of 17 weeks paclitaxel. Only 5 patients (16%) receiving WP alone had grade 3 or 4 neutropenia, and 3 patients (9%) had an episode of febrile neutropenia. In the WP+T patients, there was no grade 3 or 4 neutropenia, however, 27% of patients experienced grade 3 neuropathy. Grade 3 lethargy occurred in 6 patients (14%). Overall, 9 of 43 patients achieved a partial response (PR 21%), 15 had stable disease (SD 35%). 8 of 11 (72%) of the patients receiving WP+T achieved SD or better. The median time to progression was 133 days and 191 days in the WP alone and WP+T groups respectively. The median overall survival is 289 days in the WP alone group, and has not yet been reached in the WP+T group. Survival was not significantly associated with performance status. Conclusions: In keeping with recently published literature, we have found weekly paclitaxel to be an effective and well tolerated regimen for patients with MBC including those with poor performance status. No significant financial relationships to disclose.