Cargando…
Cisplatin shows greater efficacy than gemcitabine when combined with nab-paclitaxel in metastatic triple-negative breast cancer
Our study aimed to compare the efficacy and safety of nab-paclitaxel plus cisplatin (AP) with nab-paclitaxel plus gemcitabine (AG) in patients with metastatic breast cancer (MBC). We collected data from two single-arm, phase II MBC studies. In NCT01149798, seventy-three MBC patients received 125 mg/...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6400896/ https://www.ncbi.nlm.nih.gov/pubmed/30837503 http://dx.doi.org/10.1038/s41598-019-39314-y |
_version_ | 1783400045099352064 |
---|---|
author | Li, Yi Zhao, Yannan Gong, Chengcheng Xie, Yizhao Hu, Xichun Zhang, Jian Wang, Leiping Zhang, Sheng Cao, Jun Tao, Zhonghua Wang, Biyun |
author_facet | Li, Yi Zhao, Yannan Gong, Chengcheng Xie, Yizhao Hu, Xichun Zhang, Jian Wang, Leiping Zhang, Sheng Cao, Jun Tao, Zhonghua Wang, Biyun |
author_sort | Li, Yi |
collection | PubMed |
description | Our study aimed to compare the efficacy and safety of nab-paclitaxel plus cisplatin (AP) with nab-paclitaxel plus gemcitabine (AG) in patients with metastatic breast cancer (MBC). We collected data from two single-arm, phase II MBC studies. In NCT01149798, seventy-three MBC patients received 125 mg/m(2) nab-paclitaxel on days 1, 8 and 15 followed by 75 mg/m(2) cisplatin on day 1 of a 28-day cycle. In NCT01550848, eighty-four MBC patients received 125 mg/m(2) nab-paclitaxel and 800 mg/m(2) gemcitabine on days 1, 8, and 15 of a 28-day cycle. The endpoints were the overall response rate (ORR), progression-free survival (PFS), overall survival (OS) and safety profiles of these regimens. Among the 157 patients included, the ORR were 67.1% and 52.4% for the AP and AG arms, respectively (odds ratio [OR] = 0.246; hazard ratio [HR] = 1.485; 95% confidence interval [CI], 0.762–2.985). After median follow-up periods of 26.3 and 23.3 months in the AP and AG arms, the median PFS were 9.8 months (95%CI, 8.1–11.6) and 8.1 months (95%CI, 6.8–9.4), respectively, while the median OS were 26.9 months (95%CI, 22.4–31.4) and 25.5 months (95%CI, 19.3–31.4), respectively. Neither PFS nor OS adjusted for the number of metastases, occurrence of liver metastasis and chemotherapeutic lines differed significantly between the two arms (PFS:HR = 0.769; 95%CI, 0.541–1.092; p = 0.142; OS:HR = 0.686; 95%CI, 0.426–1.104; p = 0.120). However, PFS was significantly better with AP than with AG in metastatic triple-negative breast cancer (mTNBC) patients (HR = 0.308; 95%CI, 0.129–0.732; p = 0.008). Adverse events were more common with AP than with AG, except for edema and myalgia. Both regimens showed substantial efficacy and were tolerated well in MBC patients. mTNBC who received AP rather than AG showed longer PFS. However, adverse events were more common with AP. Thus, AP may be worth recommending to mTNBC, while AG may be a better alternative for MBC patients with other subtypes. |
format | Online Article Text |
id | pubmed-6400896 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-64008962019-03-07 Cisplatin shows greater efficacy than gemcitabine when combined with nab-paclitaxel in metastatic triple-negative breast cancer Li, Yi Zhao, Yannan Gong, Chengcheng Xie, Yizhao Hu, Xichun Zhang, Jian Wang, Leiping Zhang, Sheng Cao, Jun Tao, Zhonghua Wang, Biyun Sci Rep Article Our study aimed to compare the efficacy and safety of nab-paclitaxel plus cisplatin (AP) with nab-paclitaxel plus gemcitabine (AG) in patients with metastatic breast cancer (MBC). We collected data from two single-arm, phase II MBC studies. In NCT01149798, seventy-three MBC patients received 125 mg/m(2) nab-paclitaxel on days 1, 8 and 15 followed by 75 mg/m(2) cisplatin on day 1 of a 28-day cycle. In NCT01550848, eighty-four MBC patients received 125 mg/m(2) nab-paclitaxel and 800 mg/m(2) gemcitabine on days 1, 8, and 15 of a 28-day cycle. The endpoints were the overall response rate (ORR), progression-free survival (PFS), overall survival (OS) and safety profiles of these regimens. Among the 157 patients included, the ORR were 67.1% and 52.4% for the AP and AG arms, respectively (odds ratio [OR] = 0.246; hazard ratio [HR] = 1.485; 95% confidence interval [CI], 0.762–2.985). After median follow-up periods of 26.3 and 23.3 months in the AP and AG arms, the median PFS were 9.8 months (95%CI, 8.1–11.6) and 8.1 months (95%CI, 6.8–9.4), respectively, while the median OS were 26.9 months (95%CI, 22.4–31.4) and 25.5 months (95%CI, 19.3–31.4), respectively. Neither PFS nor OS adjusted for the number of metastases, occurrence of liver metastasis and chemotherapeutic lines differed significantly between the two arms (PFS:HR = 0.769; 95%CI, 0.541–1.092; p = 0.142; OS:HR = 0.686; 95%CI, 0.426–1.104; p = 0.120). However, PFS was significantly better with AP than with AG in metastatic triple-negative breast cancer (mTNBC) patients (HR = 0.308; 95%CI, 0.129–0.732; p = 0.008). Adverse events were more common with AP than with AG, except for edema and myalgia. Both regimens showed substantial efficacy and were tolerated well in MBC patients. mTNBC who received AP rather than AG showed longer PFS. However, adverse events were more common with AP. Thus, AP may be worth recommending to mTNBC, while AG may be a better alternative for MBC patients with other subtypes. Nature Publishing Group UK 2019-03-05 /pmc/articles/PMC6400896/ /pubmed/30837503 http://dx.doi.org/10.1038/s41598-019-39314-y Text en © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Article Li, Yi Zhao, Yannan Gong, Chengcheng Xie, Yizhao Hu, Xichun Zhang, Jian Wang, Leiping Zhang, Sheng Cao, Jun Tao, Zhonghua Wang, Biyun Cisplatin shows greater efficacy than gemcitabine when combined with nab-paclitaxel in metastatic triple-negative breast cancer |
title | Cisplatin shows greater efficacy than gemcitabine when combined with nab-paclitaxel in metastatic triple-negative breast cancer |
title_full | Cisplatin shows greater efficacy than gemcitabine when combined with nab-paclitaxel in metastatic triple-negative breast cancer |
title_fullStr | Cisplatin shows greater efficacy than gemcitabine when combined with nab-paclitaxel in metastatic triple-negative breast cancer |
title_full_unstemmed | Cisplatin shows greater efficacy than gemcitabine when combined with nab-paclitaxel in metastatic triple-negative breast cancer |
title_short | Cisplatin shows greater efficacy than gemcitabine when combined with nab-paclitaxel in metastatic triple-negative breast cancer |
title_sort | cisplatin shows greater efficacy than gemcitabine when combined with nab-paclitaxel in metastatic triple-negative breast cancer |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6400896/ https://www.ncbi.nlm.nih.gov/pubmed/30837503 http://dx.doi.org/10.1038/s41598-019-39314-y |
work_keys_str_mv | AT liyi cisplatinshowsgreaterefficacythangemcitabinewhencombinedwithnabpaclitaxelinmetastatictriplenegativebreastcancer AT zhaoyannan cisplatinshowsgreaterefficacythangemcitabinewhencombinedwithnabpaclitaxelinmetastatictriplenegativebreastcancer AT gongchengcheng cisplatinshowsgreaterefficacythangemcitabinewhencombinedwithnabpaclitaxelinmetastatictriplenegativebreastcancer AT xieyizhao cisplatinshowsgreaterefficacythangemcitabinewhencombinedwithnabpaclitaxelinmetastatictriplenegativebreastcancer AT huxichun cisplatinshowsgreaterefficacythangemcitabinewhencombinedwithnabpaclitaxelinmetastatictriplenegativebreastcancer AT zhangjian cisplatinshowsgreaterefficacythangemcitabinewhencombinedwithnabpaclitaxelinmetastatictriplenegativebreastcancer AT wangleiping cisplatinshowsgreaterefficacythangemcitabinewhencombinedwithnabpaclitaxelinmetastatictriplenegativebreastcancer AT zhangsheng cisplatinshowsgreaterefficacythangemcitabinewhencombinedwithnabpaclitaxelinmetastatictriplenegativebreastcancer AT caojun cisplatinshowsgreaterefficacythangemcitabinewhencombinedwithnabpaclitaxelinmetastatictriplenegativebreastcancer AT taozhonghua cisplatinshowsgreaterefficacythangemcitabinewhencombinedwithnabpaclitaxelinmetastatictriplenegativebreastcancer AT wangbiyun cisplatinshowsgreaterefficacythangemcitabinewhencombinedwithnabpaclitaxelinmetastatictriplenegativebreastcancer |