Giving either of two newer and more costly drugs, nanoparticle albumin-bound paclitaxel (Abraxane; called nab-paclitaxel) and ixabepilone (Ixempra), did not work better to treat locally advanced or metastatic breast cancer than standard chemotherapy with paclitaxel, according to a large study. Locally advanced breast cancer is cancer that has spread to parts of the body near the breast. Metastatic breast cancer has spread to other, more distant parts of the body.
The 799 patients who participated in this study received weekly cycles or rounds of treatment with either paclitaxel, nab-paclitaxel, or ixabepilone for three weeks followed by a one-week break. Researchers found that paclitaxel kept the cancer from worsening for about 11 months, compared with about nine months for those given nab-paclitaxel and about eight months for those given ixabepilone.
Researchers also found that 16% of the patients who received paclitaxel developed severe neuropathy (nerve damage), compared with 25% of the patients who received nab-paclitaxel and ixabepilone. However, patients who received ixabepilone were less likely to have side effects related to low levels of blood cells, such as an increased risk of infection, fatigue, and blood clotting problems. For patients receiving paclitaxel, 21% developed blood-related side effects, compared with 12% of those receiving ixabepilone and 51% of those given nab-paclitaxel.
What this means for patients
“We wanted to know if giving these newer drugs on a weekly schedule would result in similar or better effectiveness with fewer side effects than the standard weekly paclitaxel regimen,” said lead author Hope S. Rugo, MD, Professor of Medicine and Director of Breast Oncology and Clinical Trials Education at the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center. “This study shows that we should not assume that newer drugs are always better than the standard therapies. In metastatic breast cancer, we are constantly examining and refining dosing schedules, testing new therapies, and looking closely at the features of patients' tumors to find the right treatment for the right patient with the fewest side effects.” Talk with your doctor about the possible side effects of each treatment option as well as the costs you may need to pay.
Questions to Ask Your Doctor
- What stage of breast cancer do I have? What does this mean?
- What are my treatment options?
- What treatment plan do you recommend? Why?
- Will chemotherapy with paclitaxel be part of my treatment or will other drugs be used?
- If I'm worried about managing the costs of my cancer care, who can help me with those concerns?
- What are the possible side effects of treatment? How can they be managed?
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