Effectiveness and Tolerability of Nab-paclitaxel in Younger versus Elderly Patients With Metastatic HR-positive/HER2-negative Breast Cancer: Results From the Noninterventional, Prospective Study NABUCCO.
Adult
Aged
Aged, 80 and over
Albumins
/ administration & dosage
Antineoplastic Combined Chemotherapy Protocols
/ administration & dosage
Biomarkers, Tumor
/ analysis
Breast
/ pathology
Breast Neoplasms
/ diagnosis
Chemotherapy, Adjuvant
/ adverse effects
Disease-Free Survival
Female
Humans
Mastectomy
Middle Aged
Neoplasm Staging
Paclitaxel
/ administration & dosage
Peripheral Nervous System Diseases
/ chemically induced
Progression-Free Survival
Prospective Studies
Quality of Life
Receptor, ErbB-2
/ analysis
Receptors, Estrogen
/ analysis
Receptors, Progesterone
/ analysis
albumin-bound paclitaxel
breast neoplasms
health services for the aged
peripheral neuropathies
taxanes
Journal
Clinical breast cancer
ISSN: 1938-0666
Titre abrégé: Clin Breast Cancer
Pays: United States
ID NLM: 100898731
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
26
07
2019
accepted:
08
11
2019
pubmed:
11
4
2020
medline:
22
6
2021
entrez:
11
4
2020
Statut:
ppublish
Résumé
There are only scarce data on treatment of elderly patients with nab-paclitaxel for metastatic breast cancer, especially from the real-world setting. Here we present data from the noninterventional study NABUCCO with special focus on taxane-induced peripheral neuropathy (TIPN) in younger and elderly patients. A total of 407 patients with HR-positive/HER2-negative metastatic breast cancer were enrolled between April 2012 and April 2015 into the prospective, multicenter, noninterventional study NABUCCO. Details on effectiveness, tolerability, and safety of nab-paclitaxel were evaluated for younger (<70 years) and elderly (≥70 years) patients. Neither median time to progression (TTP, younger 6.0 months, 95% confidence interval [CI], 5.5-7.1; elderly 6.9 months, 95% CI, 5.5-8.6) nor median overall survival (younger 16.4 months, 95% CI, 14.2-18.1; elderly 14.5 months, 95% CI, 11.9-17.4) differed by age group, also not in view of prior treatments. A multivariate regression model revealed that age did not significantly influence the TTP. TIPN was reported by 49.0% younger (44.3% common terminology criteria for adverse events [CTCAE] grade 1/2, 4.7% grade 3/4) and 45.8% elderly patients (41.1% CTCAE grade 1/2, 4.7% grade 3/4). The cumulative nab-paclitaxel dose did not correlate with the severity/grading of TIPN. Treatment with nab-paclitaxel in first- or further-line of metastatic HR-positive/HER2-negative breast cancer resulted in similar effectiveness and safety, irrespective of age. Therefore, nab-paclitaxel is a valid treatment option for elderly and partially heavily pretreated patients. However, incidence of TIPN is high, influencing the patients' quality of life. A close monitoring and awareness for early TIPN symptoms is warranted.
Sections du résumé
BACKGROUND
There are only scarce data on treatment of elderly patients with nab-paclitaxel for metastatic breast cancer, especially from the real-world setting. Here we present data from the noninterventional study NABUCCO with special focus on taxane-induced peripheral neuropathy (TIPN) in younger and elderly patients.
PATIENTS AND METHODS
A total of 407 patients with HR-positive/HER2-negative metastatic breast cancer were enrolled between April 2012 and April 2015 into the prospective, multicenter, noninterventional study NABUCCO. Details on effectiveness, tolerability, and safety of nab-paclitaxel were evaluated for younger (<70 years) and elderly (≥70 years) patients.
RESULTS
Neither median time to progression (TTP, younger 6.0 months, 95% confidence interval [CI], 5.5-7.1; elderly 6.9 months, 95% CI, 5.5-8.6) nor median overall survival (younger 16.4 months, 95% CI, 14.2-18.1; elderly 14.5 months, 95% CI, 11.9-17.4) differed by age group, also not in view of prior treatments. A multivariate regression model revealed that age did not significantly influence the TTP. TIPN was reported by 49.0% younger (44.3% common terminology criteria for adverse events [CTCAE] grade 1/2, 4.7% grade 3/4) and 45.8% elderly patients (41.1% CTCAE grade 1/2, 4.7% grade 3/4). The cumulative nab-paclitaxel dose did not correlate with the severity/grading of TIPN.
CONCLUSION
Treatment with nab-paclitaxel in first- or further-line of metastatic HR-positive/HER2-negative breast cancer resulted in similar effectiveness and safety, irrespective of age. Therefore, nab-paclitaxel is a valid treatment option for elderly and partially heavily pretreated patients. However, incidence of TIPN is high, influencing the patients' quality of life. A close monitoring and awareness for early TIPN symptoms is warranted.
Identifiants
pubmed: 32273207
pii: S1526-8209(19)30734-7
doi: 10.1016/j.clbc.2019.11.003
pii:
doi:
Substances chimiques
130-nm albumin-bound paclitaxel
0
Albumins
0
Biomarkers, Tumor
0
Receptors, Estrogen
0
Receptors, Progesterone
0
ERBB2 protein, human
EC 2.7.10.1
Receptor, ErbB-2
EC 2.7.10.1
Paclitaxel
P88XT4IS4D
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e315-e326Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.