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Short-term outcomes of albumin-bound paclitaxel (abraxane)-containing chemotherapy in patients with advanced gastric cancer: a report of 14 cases

  • Zheng Yan
  • Liangping Xia
  • Huijuan Qiu
  • Ping Chen
  • Bei ZhangEmail author
Article

Abstract

Objective

Albumin-bound paclitaxel (abraxane, ABX) has more favorable efficacy and less toxicity than conventional taxanes. However, the data of ABX in advanced gastric cancer (AGC) treatment is unavailable. The current study was designed to summarize our experience in treating AGC patients with ABX.

Methods

The clinical data of patients with AGC who had received at least one cycle of ABX-based chemotherapy in Sun Yat-sen University Cancer Center from January 10th 2010 to May 14th 2012 was retrospectively analyzed..

Results

A total of 47 cycles of ABX-containing regimens, with a median of 3 cycles (range: 1–8 cycles), were administered to 14 patients. Five (35.7%) partial responses and 6 (42.9%) stable diseases were obtained, with a disease control rate (DCR) of 78.6%. The median progression free survival (PFS) and overall survival (OS) were 3.3 and 10.8 months, respectively. Interestingly, patients in the first-line setting achieved a DCR of 100% (8/8). Neutropenia and thrombocytopenia were the main grade 3/4 adverse events with an incidence of 50% in the whole group. However, only 25% patients (2/8) experienced grade 3 neutropenia when ABX in combination with fluoropyrimidines.

Conclusion

The activity of ABX-based regimens as first-line therapy for patients with AGC is remarkable, and the toxicity is mild when ABX combined with fluoropyrimidines. Further prospective clinical trials of ABX-based chemotherapy as first-line treatment for AGC are strongly anticipated.

Key words

albumin-bound paclitaxel (abraxane, ABX) gastric cancer efficacy toxicity chemotherapy 

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References

  1. 1.
    Zhang JA, Anyarambhatla G, Ma L, et al. Development and characterization of a novel Cremophor (R) EL free liposome-based paclitaxel (LEP-ETU) formulation. Eur J Pharm Biopharm, 2005, 59: 177–187.PubMedCrossRefGoogle Scholar
  2. 2.
    Weiss RB, Donehower RC, Wiernik PH, et al. Hypersensitivity Reactions from Taxol. J Clin Oncol, 1990, 8: 1263–1268.PubMedGoogle Scholar
  3. 3.
    Sparreboom A, van Zuylen L, Brouwer E, et al. Cremophor EL-mediated alteration of paclitaxel distribution in human blood: clinical pharmacokinetic implications. Cancer Res, 1999, 59: 1454–1457.PubMedGoogle Scholar
  4. 4.
    Harries M, Ellis P, Harper P. Nanoparticle albumin-bound paclitaxel for metastatic breast cancer. J Clin Oncol, 2005, 23: 7768–7771.PubMedCrossRefGoogle Scholar
  5. 5.
    Engels FK, Mathot RAA, Verweij J. Alternative drug formulations of docetaxel: a review. Anticancer Drugs, 2007, 18: 95–103.PubMedCrossRefGoogle Scholar
  6. 6.
    John TA, Vogel SM, Tiruppathi C, et al. Quantitative analysis of albumin uptake and transport in the rat microvessel endothelial monolayer. Am J Physiol Lung Cell Mol Physiol, 2003, 284: 187–196.Google Scholar
  7. 7.
    Nyman DW, Campbell KJ, Hersh E, et al. Phase I and pharmacokinetics trial of ABI-007, a novel nanoparticle formulation of paclitaxel in patients with advanced nonhematologic malignancies. J Clin Oncol, 2005, 23: 7785–7793.PubMedCrossRefGoogle Scholar
  8. 8.
    Ibrahim NK, Desai N, Legha S, et al. Phase I and pharmacokinetic study of ABI-007, a cremophor-free, protein-stabilized, nanoparticle formulation of paclitaxel. Clin Cancer Res, 2002, 8: 1038–1044.PubMedGoogle Scholar
  9. 9.
    Gradishar WJ, Tjulandin S, Davidson N, et al. Phase III trial of nanoparticle albumin-bound paclitaxel compared with polyethylated castor oil-based paclitaxel in women with breast cancer. J Clin Oncol, 2005, 23: 7794–7803.PubMedCrossRefGoogle Scholar
  10. 10.
    Hersh EM, O’Day SJ, Ribas A, et al. A Phase 2 Clinical Trial of nab-Paclitaxel in Previously Treated and Chemotherapy-Naive Patients With Metastatic Melanoma. Cancer, 2010, 116: 155–163.PubMedGoogle Scholar
  11. 11.
    Kottschade LA, Suman VJ, Amatruda T 3rd, et al. A phase II trial of nab-paclitaxel (ABI-007) and carboplatin in patients with unresectable stage IV melanoma: a North Central Cancer Treatment Group Study, N057E (1). Cancer, 2011, 117: 1704–1710.PubMedCrossRefGoogle Scholar
  12. 12.
    Von Hoff DD, Ramanathan RK, Borad MJ, et al. Gemcitabine plus nab-paclitaxel is an active regimen in patients with advanced pancreatic cancer: a phase I/II trial. J Clin Oncol, 2011, 29: 4548–4554.CrossRefGoogle Scholar
  13. 13.
    Hosein PJ, de Lima Lopes G Jr, Pastorini VH, et al. A phase II trial of nab-paclitaxel as second-line therapy in patients with advanced pancreatic cancer. Am J Clin Oncol, 2012, Feb 2.Google Scholar
  14. 14.
    Teneriello MG, Tseng PC, Crozier M, et al. Phase II evaluation of nanoparticle albumin-bound paclitaxel in platinum-sensitive patients with recurrent ovarian, peritoneal, or fallopian tube cancer. J Clin Oncol, 2009, 27: 1426–1431.PubMedCrossRefGoogle Scholar
  15. 15.
    Agheli A, Park SC, Huang CJ, et al. Apparent beneficial effects by nab-paclitaxel in the treatment of refractory metastatic ovarian carcinoma. Anticancer Drugs, 2009, 20: 525–526.PubMedCrossRefGoogle Scholar
  16. 16.
    Shepard DR, Dreicer R, Garcia J, et al. Phase II trial of neoadjuvant nab-paclitaxel in high risk patients with prostate cancer undergoing radical prostatectomy. J Urol, 2009, 181: 1672–1677.PubMedCrossRefGoogle Scholar
  17. 17.
    Rizvi NA, Riely GJ, Azzoli CG, et al. Phase I/II trial of weekly intravenous 130-nm albumin-bound paclitaxel as initial chemotherapy in patients with stage IV non-small-cell lung cancer. J Clin Oncol, 2008, 26: 639–643.PubMedCrossRefGoogle Scholar
  18. 18.
    Reynolds C, Barrera D, Jotte R, et al. Phase II trial of nanoparticle albumin-bound paclitaxel, carboplatin, and bevacizumab in first-line patients with advanced nonsquamous non-small cell lung cancer. J Thorac Oncol, 2009, 4: 1537–1543.PubMedCrossRefGoogle Scholar
  19. 19.
    Li P, Wang Q, Wang H, et al. Research progresses of albumin-bound paclitaxel in the treatment of non-small cell lung cancer. Chin J lung cancer (Chinese), 2010, 13: 748–752.Google Scholar
  20. 20.
    Socinski MA, Manikhas GM, Stroyakovsky DL, et al. A dose finding study of weekly and every-3-week nab-Paclitaxel followed by carboplatin as first-line therapy in patients with advanced non-small cell lung cancer. J Thora Oncol, 2010, 5: 852–861.CrossRefGoogle Scholar
  21. 21.
    Socinski MA, Bondarenko I, Karaseva NA, et al. Weekly nab-paclitaxel in combination with carboplatin versus solvent-based paclitaxel plus carboplatin as first-line therapy in patients with advanced non-small-cell lung cancer: final results of a phase III trial. J Clin Oncol, 2012, 30: 2055–2062.PubMedCrossRefGoogle Scholar
  22. 22.
    Coleman RL, Brady WE, McMeekin DS, et al. A phase II evaluation of nanoparticle, albumin-bound (nab) paclitaxel in the treatment of recurrent or persistent platinum-resistant ovarian, fallopian tube, or primary peritoneal cancer: a Gynecologic Oncology Group study. Gynecol Oncol, 2011, 122: 111–115.PubMedCrossRefGoogle Scholar
  23. 23.
    Desai N, Trieu V, Yao R, et al. SPARC expression in breast tumors may correlate to increased tumor distribution of nanoparticle albuminbound paclitaxel (ABI-007) vs taxol. Breast Cancer Res Treat, 2004, 88: S26–S27.Google Scholar
  24. 24.
    Gradishar WJ. Albumin-bound paclitaxel: a next-generation taxane. Expert Opin Pharmacother, 2006, 7: 1041–1053.PubMedCrossRefGoogle Scholar
  25. 25.
    Desai NP, Trieu V, Hwang LY, et al. Improved effectiveness of nanoparticle albumin-bound (nab) paclitaxel versus polysorbate-based docetaxel in multiple xenografts as a function of HER2 and SPARC status. Anticancer Drugs. 2008, 19: 899–909.PubMedCrossRefGoogle Scholar
  26. 26.
    Desai N, Trieu V, Knauer D, et al. SPARC may be a predictive biomarker of response to nab-paclitaxel. Ejc Suppl, 2009, 7: 88.Google Scholar
  27. 27.
    Desai N, Trieu V, Damascelli B, et al. SPARC expression correlates with tumor response to albumin-bound paclitaxel in head and neck cancer patients. Transl Oncol, 2009, 2: 59–64.PubMedGoogle Scholar
  28. 28.
    Rocken C, Carl-McGrath S, Lendeckel U, et al. The expression of SPARC in tumor stroma may facilitate gastric cancer metastasis and invasion. Gastroenterology, 2006, 130: A470.CrossRefGoogle Scholar
  29. 29.
    Zhao ZS, Wang YY, Chu YQ, et al. SPARC is associated with gastric cancer progression and poor survival of patients. Clin Cancer Res, 2010, 16: 260–268.PubMedCrossRefGoogle Scholar
  30. 30.
    Franke K, Carl-McGrath S, Rohl FW, et al. Differential expression of SPARC in intestinal-type gastric cancer correlates with tumor progression and nodal Spread. Transl Oncol, 2009, 2: 310–320.PubMedGoogle Scholar
  31. 31.
    Jeung HC, Rha SY, Im CK, et al. A randomized phase 2 study of docetaxel and S-1 versus docetaxel and cisplatin in advanced gastric cancer with an evaluation of SPARC expression for personalized therapy. Cancer, 2011, 117: 2050–2057.PubMedCrossRefGoogle Scholar
  32. 32.
    Yin J, Chen GW, Liu YC, et al. Downregulation of SPARC expression decreases gastric cancer cellular invasion and survival. J Exp Clin Canc Res, 2010, 29: 59.CrossRefGoogle Scholar
  33. 33.
    Desai N, Trieu V, Yao Z. Increased antitumor activity, intratumor paclitaxel concentrations, and endothelial cell transport of cremophor-free, albumin-bound paclitaxel, ABI-007, compared with cremophor-based paclitaxel. Clin Cancer Res, 2006, 12: 3869–3869.CrossRefGoogle Scholar
  34. 34.
    Yamada K, Yamamoto N, Yamada Y, et al. Phase I and pharmacokinetic study of ABI-007, albumin-bound paclitaxel, administered every 3 weeks in Japanese patients with solid tumors. Jpn J Clin Oncol, 2010, 40: 404–411.PubMedCrossRefGoogle Scholar
  35. 35.
    Gradishar W, Krasnojon D, Cheporov S, et al. Randomized comparison of nab-paclitaxel weekly or every 3 weeks compared to docetaxel every 3 weeks as first-line therapy in patients (pts) with metastatic breast cancer (MBC). Ejc Supplements, 2008, 6: 172–172.Google Scholar
  36. 36.
    Huang TC, Campbell TC. Comparison of weekly versus every 3 weeks paclitaxel in the treatment of advanced solid tumors: A metaanalysis. Cancer treatment Rev, 2012, 38: 613–617.CrossRefGoogle Scholar
  37. 37.
    Aapro M, Tjulandin S, Bhar P, et al. Weekly nab-paclitaxel is safe and effective in >/=65 years old patients with metastatic breast cancer: a post-hoc analysis. Breast, 2011, 20: 468–474.PubMedCrossRefGoogle Scholar
  38. 38.
    Du ZQ, Q JY, Ye H, et al. Effects of weekly dose docetaxel monotherapy schedule for elderly patients with non-small cell lung cancer. Chinese-German J Clin Oncol, 2009, 8: 9–11.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Zheng Yan
    • 1
  • Liangping Xia
    • 1
  • Huijuan Qiu
    • 1
  • Ping Chen
    • 1
  • Bei Zhang
    • 1
    Email author
  1. 1.VIP RegionSun Yat-sen University Cancer CenterGuangzhouChina

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