Efficacy and Safety of Albumin-Bound Paclitaxel Compared to Docetaxel as Neoadjuvant Chemotherapy for HER2-Negative Breast Cancer

Zhi-Dong Lv; Hong-Ming Song; Zhao-He Niu; Gang Nie; Shuai Zheng; Ying-Ying Xu; Wei Gong; Hai-Bo Wang

doi:10.3389/fonc.2021.760655

Efficacy and Safety of Albumin-Bound Paclitaxel Compared to Docetaxel as Neoadjuvant Chemotherapy for HER2-Negative Breast Cancer

Front Oncol. 2022 Jan 11:11:760655. doi: 10.3389/fonc.2021.760655. eCollection 2021.

Authors

Zhi-Dong Lv¹, Hong-Ming Song¹, Zhao-He Niu¹, Gang Nie¹, Shuai Zheng², Ying-Ying Xu³, Wei Gong⁴, Hai-Bo Wang¹

Affiliations

¹ Breast Center, The Affiliated Hospital of Qingdao University, Qingdao, China.
² Department of Breast and Thyroid Surgery, Heze Municipal Hospital, Heze, China.
³ Department of Breast Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China.
⁴ Department of Thyroid and Breast Surgery, The Second People's Hospital of Kunshan, Kunshan, China.

Abstract

Background: Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) as neoadjuvant chemotherapy (NAC) for breast cancer remains controversial. We conducted a retrospective study to compare the efficacy and safety of nab-paclitaxel with those of docetaxel as neoadjuvant regimens for HER2-negative breast cancer.

Methods: In this retrospective analysis, a total of 159 HER2-negative breast cancer patients who had undergone operation after NAC were consecutively analyzed from May 2016 to April 2018. Patients were classified into the nab-paclitaxel group (n = 79, nab-paclitaxel 260 mg/m², epirubicin 75 mg/m², and cyclophosphamide 500 mg/m²) and the docetaxel group (n = 80, docetaxel 75 mg/m², epirubicin 75 mg/m², and cyclophosphamide 500 mg/m²) according to the drug they received for neoadjuvant treatment. The efficacy and adverse events were evaluated in the two groups.

Results: The pathological complete response (pCR)(ypT0/isN0) rate was significantly higher in the nab-paclitaxel group than in the docetaxel group (36.71% vs 20.00%; P = 0.031). The multivariate analysis revealed that therapeutic drugs, lymph node status, and tumor subtype were the most significant factor influencing treatment outcome. At a median follow-up of 47 months, disease-free survival (DFS) was not significantly different in those assigned to nab-paclitaxel compared with docetaxel (82.28% vs 76.25%; P = 0.331). The incidence of peripheral sensory neuropathy in the nab-paclitaxel group was higher than that in the docetaxel group (60.76% vs 36.25%; P = 0.008), while the incidence of arthralgia was observed more frequently in the docetaxel group (57.50% vs 39.97%; P = 0.047).

Conclusions: Compared with docetaxel, nab-paclitaxel achieved a higher pCR rate, especially those patients with triple-negative breast cancer or lymph node negative breast cancer. However, there was no significant difference in DFS between the two groups. This study provides a valuable reference for the management of patients with HER2-negative breast cancer.

Keywords: Her-2-negative breast cancer; albumin-bound paclitaxel; docetaxel; neoadjuvant chemotherapy; pathological complete response.