Systematic review of ixabepilone for treating metastatic breast cancer
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Ixabepilone is now a Food and Drug Administration-approved therapeutic option for patients with metastatic breast cancer (MBC) whose disease has progressed despite prior anthracycline and taxane therapy. We conducted a systematic review and meta-analysis to systematically evaluate the efficacy and safety of ixabepilone for treating metastatic breast cancer.
A systematic review and meta-analysis were conducted. Randomized controlled studies applying ixabepilone for treating MBC were included. The primary outcome was Overall Survival (OS). The authors of primary articles were contacted and methodological quality was evaluated. Subgroups were drawn based on intervention measures; heterogeneity and bias were discussed.
Eight studies with 5247 patients were included. Compared with a weekly schedule, a triweekly schedule of ixabepilone was better at improving overall response rate (ORR), while there were no differences in improving OS and progression-free survival (PFS). Ixabepilone plus capecitabine was superior to capecitabine monotherapy in improving OS, PFS and ORR. Paclitaxel was more effective than ixabepilone in terms of OS and PFS. There was no difference in the improvement of ORR, clinical benefit rate (CBR) and disease control rate (DCR) between ixabepilone and eribulin.
Current evidence suggests that a triweekly schedule of ixabepilone is more effective than weekly dosing in improving ORR. Use of ixabepilone in combination with capecitabine possesses superior clinical efficacy to the use of capecitabine alone. Paclitaxel was more effective than ixabepilone in terms of OS and PFS. The efficacy and safety between ixabepilone and eribulin were identical.
KeywordsMetastatic breast cancer Therapy Systematic review Meta-analysis Ixabepilone
- 5.Lee F, Lewin A, Wen M, Ryseck R, Fargnoli J, Poruchynsky M, Fojo T, Mudenda B, Rugo H. Antiangiogenic (AG) synergywithixabepilone (ixa): translation of preclinical studies tothe clinical setting. Cancer Res. 2009;69:20.Google Scholar
- 11.Rugo HS, Campone M, Amadori D, Wardley AM, Aldrighetti D, Conte PF, Liu D, Mudenda B, McHenry MB. Pivot XB (2013) A randomized, phase II, three-arm study of two schedules of ixabepilone or paclitaxel plus bevacizumab as first-line therapy for metastatic breast cancer. Breast Cancer Res Treat. 2013;139:411–9.CrossRefPubMedPubMedCentralGoogle Scholar
- 17.Rugo HS, Barry WT, Aspitia AM, et al. Randomized phase III trial of paclitaxel once per week compared with nanoparticle albumin-bound nab-paclitaxel once per week or ixabepilone with bevacizumab as first-line chemotherapy for locally recurrent or metastatic breast cancer: CALGB40502/NCCTG N063H (Alliance). J Clin Oncol. 2015;33:2361–9.CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Myers Squibb Company. IXEMPRA® (ixabepilone) prescribing information. Bristol-Myers Squibb Company, Princeton, NJ.Google Scholar
- 19.Moulder S, Li H, Wang M, Gradishar WJ, Perez EA, Sparano JA, Pins M, Yang X, Sledge GW. A phase II trial of trastuzumab plus weekly ixabepilone and carboplatin in patients with HER2-positive metastatic breast cancer: an Eastern Cooperative Oncology Group Trial. Breast Cancer Res Treat. 2010;119:663–71.CrossRefPubMedPubMedCentralGoogle Scholar
- 20.Rugo HS, Campone M, Amadori D, Wardley AM, Aldrighetti D, Conte PF, Liu D, Mudenda B, McHenry MB, Pivot XB. Randomized phase II study of weekly versus every 3 week ixabepilone plus bevacizumab (ixa/bev) versus paclitaxel plus bev(pac/bev) as first-line therapy for metastatic breast cancer (MBC): final results. J Clin Oncol. 2010;28(Suppl 15):1040.Google Scholar
- 26.Towle MJ, Salvato KA, Budrow J, Wels BF, Kuznetsov G, Aalfs KK, Welsh S, Zheng W, Seletsky BM, Palme MH, Habgood GJ, Singer LA, Dipietro LV, Wang Y, Chen JJ, Quincy DA, Davis A, Yoshimatsu K, Kishi Y, Yu MJ, Littlefield BA. In vitro and in vivo anticancer activities of synthetic macrocyclic ketone analogues of halichondrin B. Cancer Res. 2001;61:1013–21.PubMedGoogle Scholar