부산대학교 도서관

Every-2-week (dose-dense) adjuvant doxorubicin (A) plus cyclophosphamide (C) followed by cremophor-formulated paclitaxel (cf-P) was efficacious in metastatic breast cancer (BC). Albumin-bound paclitaxel (ab-P) was safe and more effective than cf-P, and the addition of bevacizumab to cf-P improved efficacy. This study compared the safety of dose-dense ab-P vs cf-P plus bevacizumab following dose-dense adjuvant AC for early-stage BC. Patients and Methods: Women with operable, histologically confirmed BC were randomized to 4 cycles of dose-dense A 60 mg/[m.sup.2] plus C 600 mg/[m.sup.2] IV with SC pegfilgrastim, followed by 4 cycles of either dose-dense IV ab-P 260 mg/[m.sup.2] or cf-P 175 mg/[m.sup.2]. Bevacizumab was given during and following chemotherapy. 97 and 96% of patients completed 4 cycles of AC therapy, while 84 and 85% of patients completed 4 cycles of taxane therapy in the ab-P and cf-P arms, respectively (N = 197). Baseline patient characteristics were similar. The most common grade [greater than or equal to] 3 taxane-related adverse events (AEs) were fatigue and neutropenia. Dose reductions were similar between the treatment arms. During AC therapy, the majority of dose reductions were due to febrile neutropenia; during taxane therapy, the majority of cases were due to neuropathy. No taxane-related dose interruption occurred in the ab-P arm, while 3 occurred in the cf-P arm due to hypersensitivity reactions. The mean cumulative paclitaxel dose was 950.5 and 660.8 mg/[m.sup.2] in the ab-P and cf-P arms, respectively. A 44% higher paclitaxel dose was delivered in the ab-P compared with the cf-P arm (P < 0.0001), while achieving a similar safety profile. ab-P plus bevacizumab following AC therapy without prophylactic premedications was tolerable in early-stage BC patients. Keywords AC therapy * Albumin-bound paclitaxel * Bevacizumab * Early stage breast cancer * Dose-dense
Introduction Anthracyclines and taxanes are among the most active cytotoxic drugs for the treatment of breast cancer. Large clinical adjuvant trials, including CALGB 9344 and CALGB 9741, demonstrated that the [...]