Taxanes are a mainstay in the treatment of metastatic breast cancer ( mBC ). Combination chemotherapy, including Platinum-taxens doublets, can improve tumor responses and progression-free survival ( PFS ), but is associated with more toxicities and an uncertain benefit in terms of overall survival ( OS ).
Researchers have performed a retrospective study on 274 consecutive patients with metastatic breast cancer treated at the Division of Medical Oncology of Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy, during the decade 2007-2016 with the combination of Carboplatin AUC 2 plus Paclitaxel 80 mg/m2, both given on days 1 and 8 in every 21-day cycle.
264 patients were evaluable for treatment safety and activity.
The objective response rate ( ORR ) was 44.7%. Median progression-free survival and overall survival were 8.6 and 23.7 months, respectively.
Triple-negative breast cancer ( TNBC ) patients had significantly lower progression-free survival and overall survival times compared to other biology groups.
At multivariable analysis, previous exposure to taxanes, HR-positive HER2-negative biology, a higher number of metastatic sites, and de novo metastatic disease at diagnosis were associated with reduced progression-free survival, while receiving maintenance therapy correlated with improved progression-free survival.
Overall, the treatment was quite well tolerated, with 10.2% of patients discontinuing one or both drugs because of adverse events.
G3-G4 neutropenia occurred in 16.8% of patients, while the incidence of febrile neutropenia was 2.3%.
In conclusion, weekly Carboplatin-Paclitaxel regimen is active and well tolerated in metastatic breast cancer treatment.
Prospective studies should be conducted to compare its efficacy and tolerability with standard single-agent Paclitaxel or Docetaxel treatment schedules, as well as with more recent combination regimens. ( Xagena )
Vernieri C et al, Breast Cancer Res Treat 2017; [Epub ahead of print