Efficacy And Safety Of Nanoparticle-Albumin-bound Paclitaxel For Metastatic Breast Cancer

Background:Breast cancer is currently the most common female malignant tumor.With the improvement of early diagnosis capabilities,the requirements for the treatment of breast cancer have also increased.Chemotherapy runs through the entire course of breast cancer treatment,whether it is neoadjuvant therapy,adjuvant therapy or palliative chemotherapy.As a member of the paclitaxel family,nab-paclitaxel has shown its'advantages with the positive results of clinical trials in recent years,and has been recommended by multiple clinical guidelines.The purpose of this study is to analyze the therapeutic effects in the real-world cases,by reviewing the patients with advanced breast cancer who were treated with nab-paclitaxel retrospectively.Methods:Retrospectively reviewed 40 cases of breast cancer treated with nab-paclitaxel between January 2008 and September 2019 in Sir Run Run Shaw Hospital.These cases were collected and followed up to February 2020.StataSE 16 software was used to analyze the basic conditions,progression-free survival time(PFS),therapeutic effects,adverse events during the treatment,etc.Result:The median PFS for all patients treated with nab-paclitaxel was 4.9 months,objective response rate(ORR)reach 28.6%,and disease control rate(DCR)is 53.6%.In the multivariate Cox survival analysis,the older patients have the lower risk of disease progression(HR=0.93,p<0.05)when receiving nab-paclitaxel treatment.Compare with second-line or higher,the first-line chemotherapy of nab-paclitaxel has a longer PFS(9.2 months),and its' ORR is 60%.In the multivariate Cox survival analysis,patients who were treated with nab-paclitaxel at second-line or higher had a higher risk of disease progression than those at first-line(HR=43.37,p<0.05).There had no significant statistical difference in PFS between patients with previous taxane treatment history and those without treatment history.There had no statistical difference in PFS between different molecular subtypes of breast cancer in the treatment with nab-paclitaxel.The number of metastases before nab-paclitaxel treatment had no significant effect on PFS Myelosuppression occurs in about 80%of patients,and grade 3/4 hematological adverse events occurs around 18%-36%.Conclusion:Patients with advanced breast cancer have benefited more from first-line treatment with nab-paclitaxel.Age should not be regarded as relative contraindication for nab-paclitaxel chemotherapy.In general,the use of nab-paclitaxel is safe and reliable.