Clinical Comparison Of Albumin-binding Paclitaxel And Docetaxel In Neoadjuvant Therapy For HER-2-negative Early Breast Cancer

ObjectiveNano-albumin-bound paclitaxel,referred to as albumin-bound paclitaxel(nab-paclitaxel),Because of its good curative effect and low toxicity,it is mostly used in the treatment of metastatic breast cancer.However,the application of this drug in early breast cancer has not been fully studied.the purpose of this study was to study the clinical comparison of albumin-bound paclitaxel and docetaxel as neoadjuvant chemotherapy regimens for HER-2 negative early breast cancer.MethodsFrom June 2017 to June 2018,78 patients with stageⅠ~Ⅲhuman epidermal growth factor receptor(HER-2)negative breast cancer hospitalized in the first affiliated Hospital of Zhengzhou University were divided into group A(n=39 cases)and group B(n=39 cases).There were 21 cases of Ki67>30%in group A and 25cases of Ki67>30%in group B.received either docetaxel every 3 week or nab-paclitaxel day 1,8 and 15 every 28 day for four cycles followed by/epirubicin/cyclophosphamide every 2 weeks for four cycles.Surgical treatment was performed 1-2 weeks after chemotherapy,and the effect and adverse reactions of chemotherapy were analyzed.The primary endpoint was the pathological complete response(pCR)rate.which defined as ypT0,ypN0.Secondary end points were pCR(ypT0/is,ypN0),the clinical response rate(according to the RECIST criteria)。ResultsThe basic conditions of 78 patients in the group were the same.The PCR rate was 15%in group A and 17%in group B(p=0.724).In the Ki67>30%group,the pCR rate was higher at 14/24%(docetaxel/nab-paclitaxel)(p=0.475)in the nab-paclitaxel arm.In the TNBC group,the PCR rate was 25/27%(docetaxel/nab-paclitaxel),and the incidence of nab-paclitaxel PCR(ypT0,ypN0)was higher(p=1.000),and the difference was not statistically significant.Common adverse reactions in patients who received the docetaxel regimen were alopecia,leukopenia,neutropenia,peripheralsensoryneuropathy,and fatigue.Common adverse reactions in patients with the nab-paclitaxel regimen are leukopenia,neutropenia,nausea,alopecia,and fatigue.Among them,the incidence of neutropenia,leukopenia,fatigue and hair loss was statistically significant between the two chemotherapy regimens.ConclusionsWeekly use of 100 mg/m~2 nab-paclitaxel as neoadjuvant chemotherapy is comparable and well tolerated compared with docetaxel.From the perspective of efficacy and toxicity balance,we believe that weekly nab-paclitaxel can be recommended as a new adjuvant chemotherapy for early breast cancer.However,further research is needed to determine the optimal dose to balance efficacy and toxicity.