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Feasibility of two schedules of weekly paclitaxel in HER2-negative early breast cancer in a Brazilian community setting

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Abstract

Background

Weekly paclitaxel has been shown more effective and less toxic than the conventional three-weekly administration. The GEICAM 9906 demonstrated effectiveness and safety of a dose-dense schedule of 100 mg/m2 of paclitaxel given over 8 weeks (w). This schedule has been adopted at our institution in 2009 for HER2-negative disease, and herein, we present the first off-trial experience and compare its safety profile with that of a historical cohort of patients treated with the conventional 80 mg/m2 over 12 w schedule.

Methods

Retrospective single-center chart review of patients with locally advanced breast cancer treated with (neo)adjuvant paclitaxel-based therapy from 2008 to 2012 with (1) 80 mg/m2 for 12 w or (2) 100 mg/m2 for 8 w. Adverse events were graded according to common terminology criteria for adverse events (CTCAE) 4.0.

Results

A total of 326 patients were analyzed. Median age was 52 (±10.9). Seventy and 256 patients received schedule (1) and (2), respectively. No significant difference was observed in the incidence of grade (G) 3/4 toxicity: pneumonitis (2.8 vs 0.3 % p = 0.097); neuropathy (2.8 vs 0.7 % p = 0.303); hand–foot syndrome (1.4 vs 0.3 % p = 0.538); anemia (0 vs 0.6 % p = 0.624); and neutropenia (5.7 vs 6.2 % p = 0.408). Also, no significant difference was seen when comparing all grades toxicity. Schedule (2) had higher dose intensity: 97.72 vs 77.07 mg/m2 per week (p < 0.0001).

Conclusions

Weekly paclitaxel given according to GEICAM 9906 is pragmatic and well tolerated, with safety profile consistent with the conventional schedule. In addition to being convenient to patients, it may also be cost-effective because of a lower number of clinic visits and infusions.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Division of Medical Oncology, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina, Universidade de São Paulo, Av. Dr. Arnaldo 251, 5º andar, CEP: 01246-000, São Paulo, SP, Brazil

    Iuri A. Santana, Julia Andrade Oliveira, Julianne Maria da Silva Lima, Laura Testa, José Roberto M. Piato, Paulo M. Hoff & Max S. Mano

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  1. Iuri A. Santana
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  2. Julia Andrade Oliveira
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  3. Julianne Maria da Silva Lima
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  4. Laura Testa
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  7. Max S. Mano
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Correspondence to Iuri A. Santana.

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Santana, I.A., Oliveira, J.A., da Silva Lima, J.M. et al. Feasibility of two schedules of weekly paclitaxel in HER2-negative early breast cancer in a Brazilian community setting. Breast Cancer 23, 261–265 (2016). https://doi.org/10.1007/s12282-014-0564-9

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  • DOI: https://doi.org/10.1007/s12282-014-0564-9

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