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A pilot study of adjuvant nanoparticle albumin-bound (nab) paclitaxel and cyclophosphamide, with trastuzumab in HER2-positive patients, in the treatment of early-stage breast cancer

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Abstract

nab-Paclitaxel has shown favorable efficacy and toxicity profiles compared to other taxanes in the treatment of metastatic breast cancer. In this pilot trial, we evaluated a nab-paclitaxel-containing adjuvant regimen in patients with early stage breast cancer. Patients with node-positive or high-risk node-negative early-stage breast cancer were eligible following completion of standard primary therapy. All the patients received four cycles, at 21-day intervals, of nab-paclitaxel (100 mg/m2 IV days 1, 8, and 15) and cyclophosphamide (600 mg/m2 IV day 1). HER2-positive patients also received trastuzumab 8 mg/kg IV on cycle 1 day 1, followed by 6 mg/kg every 21 days for a total of 52 weeks. The purpose of this trial was to evaluate feasibility and toxicity of this nab-paclitaxel-containing adjuvant regimen. 62 patients were treated between 2/08 and 11/08. The majority of the patients (87%) were HER2-negative. This adjuvant regimen was well tolerated, and full doses of all agents were administered in >90% of cycles. Grade 3/4 neutropenia occurred in 53% of the patients; however, only one episode of febrile neutropenia occurred in a total of 249 cycles administered. Other grade 3/4 adverse events occurred in less than 5% of patients. After short follow-up, all the patients remain alive and disease-free. The combination of nab-paclitaxel and cyclophosphamide, with or without trastuzumab, is feasible and well tolerated in patients with early stage breast cancer. Further investigation of the role of nab-paclitaxel in adjuvant breast cancer therapy is indicated, but definitive evaluation will require randomized phase III trials.

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Authors and Affiliations

  1. Sarah Cannon Research Institute, 3322 West End Avenue Suite 900, Nashville, TN, 37203, USA

    Denise Yardley, Howard Burris III & John Hainsworth

  2. Tennessee Oncology, PLLC, Nashville, TN, USA

    Denise Yardley, Howard Burris III, Nancy Peacock, Eric Raefsky, Dianna Shipley & John Hainsworth

  3. Grand Rapids Clinical Oncology Program Grand Rapids, Grand Rapids, MI, USA

    Marianne Melnik

  4. Mercy Hospital Portland, Portland, ME, USA

    Roger Inhorn

Authors
  1. Denise Yardley
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  2. Howard Burris III
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  3. Nancy Peacock
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  4. Eric Raefsky
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  5. Marianne Melnik
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  6. Roger Inhorn
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  7. Dianna Shipley
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  8. John Hainsworth
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Corresponding author

Correspondence to John Hainsworth.

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Supported in part by a grant from Abraxis Bioscience, LLC.

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Yardley, D., Burris, H., Peacock, N. et al. A pilot study of adjuvant nanoparticle albumin-bound (nab) paclitaxel and cyclophosphamide, with trastuzumab in HER2-positive patients, in the treatment of early-stage breast cancer. Breast Cancer Res Treat 123, 471–475 (2010). https://doi.org/10.1007/s10549-010-1047-0

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  • DOI: https://doi.org/10.1007/s10549-010-1047-0

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