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Antitumor activity and safety profile of weekly carboplatin plus paclitaxel in metastatic breast cancer: a ten-year, monocentric, retrospective study

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Abstract

Background

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).

Methods

We performed a retrospective study on 274 consecutive patients with mBC 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.

Results

264 patients were evaluable for treatment safety and activity. The objective response rate (ORR) was 44.7%. Median PFS and OS were 8.6 and 23.7 months, respectively. Triple-negative breast cancer (TNBC) patients had significantly lower PFS and OS 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 PFS, while receiving maintenance therapy correlated with improved PFS. Overall, the treatment was quite well tolerated, with 10.2% of patients discontinuing one or both drugs because of adverse events (AEs). G3–G4 neutropenia occurred in 16.8% of patients, while the incidence of febrile neutropenia was 2.3%.

Conclusions

Weekly carboplatin–paclitaxel regimen is active and well tolerated in mBC 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.

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References

  1. American Cancer Society (2015) Cancer facts & figures 2015. American Cancer Society, Atlanta

  2. Baselga J, Cortes J, Kim SB et al (2012) Pertuzumab plus trastuzumab plus docetaxel for metastatic breast cancer. N Engl J Med 366(2):109–119

    Article  CAS  PubMed  Google Scholar 

  3. Verma S, Miles D, Gianni L et al (2012) Trastuzumab emtansine for HER2-positive advanced breast cancer. N Engl J Med 367(19):1783–1791

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Baselga J, Campone M, Piccart M et al (2012) Everolimus in postmenopausal hormone-receptor-positive advanced breast cancer. N Engl J Med 366(6):520–529

    Article  CAS  PubMed  Google Scholar 

  5. Turner NC, Ro J, Andre F et al (2015) Palbociclib in hormone-receptor-positive advanced breast cancer. N Engl J Med 373(3):209–219

    Article  CAS  PubMed  Google Scholar 

  6. Hortobagyi GN, Stemmer SM, Burris HA et al (2016) Ribociclib as first-line therapy for HR-positive, advanced breast cancer. N Engl J Med 375(18):1738–1748

    Article  CAS  PubMed  Google Scholar 

  7. Seidman AD, Berry D, Cirrincione C et al (2008) Randomized phase III trial of weekly compared with every-3-weeks paclitaxel for metastatic breast cancer, with trastuzumab for all HER-2 overexpressors and random assignment to trastuzumab or not in HER-2 nonoverexpressors: final results of Cancer and Leukemia Group B protocol 9840. J Clin Oncol 26(10):1642–1649

    Article  CAS  PubMed  Google Scholar 

  8. Stemmler HJ, Harbeck N, Groll de Rivera I et al (2010) Prospective multicenter randomized phase III study of weekly versus standard docetaxel (D2) for first-line treatment of metastatic breast cancer. Oncology 79(3–4):197–203

    Article  CAS  PubMed  Google Scholar 

  9. Rivera E, Mejia JA, Arun BK et al (2008) Phase 3 study comparing the use of docetaxel on an every-3-week versus weekly schedule in the treatment of metastatic breast cancer. Cancer 112(7):1455–1461

    Article  CAS  PubMed  Google Scholar 

  10. Mauri D, Kamposioras K, Tsali L et al (2010) Overall survival benefit for weekly vs. three-weekly taxanes regimens in advanced breast cancer: a meta-analysis. Cancer Treat Rev 36(1):69–74

    Article  CAS  PubMed  Google Scholar 

  11. Qi WX, Shen Z, Lin F et al (2013) Paclitaxel-based versus docetaxel-based regimens in metastatic breast cancer: a systematic review and meta-analysis of randomized controlled trials. Curr Med Res Opin 29(2):117–125

    Article  CAS  PubMed  Google Scholar 

  12. Dear RF, McGeechan K, Jenkins MC et al (2013) Combination versus sequential single agent chemotherapy for metastatic breast cancer. Cochrane Database Syst Rev. doi:10.1002/14651858.CD008792.pub2

    PubMed  Google Scholar 

  13. Carrick S, Parker S, Thornton CE et al (2009) Single agent versus combination chemotherapy for metastatic breast cancer. Cochrane Database Syst Rev. doi:10.1002/14651858.CD003372.pub3

    PubMed  Google Scholar 

  14. Fountzilas G, Kalofonos HP, Dafni U et al (2004) Paclitaxel and epirubicin versus paclitaxel and carboplatin as first-line chemotherapy in patients with advanced breast cancer: a phase III study conducted by the Hellenic Cooperative Oncology Group. Ann Oncol 15(10):1517–1526

    Article  CAS  PubMed  Google Scholar 

  15. Perez EA, Hillman DW, Stella PJ et al (2000) A phase II study of paclitaxel plus carboplatin as first-line chemotherapy for women with metastatic breast carcinoma. Cancer 88(1):124–131

    Article  CAS  PubMed  Google Scholar 

  16. Perez EA, Suman VJ, Rowland KM et al (2005) Two concurrent phase II trials of paclitaxel/carboplatin/trastuzumab (weekly or every-3-week schedule) as first-line therapy in women with HER2-overexpressing metastatic breast cancer: NCCTG study 983252. Clin Breast Cancer 6(5):425–432

    Article  CAS  PubMed  Google Scholar 

  17. Burris H 3rd, Yardley D, Jones S et al (2004) Phase II trial of trastuzumab followed by weekly paclitaxel/carboplatin as first-line treatment for patients with metastatic breast cancer. J Clin Oncol 22(9):1621–1629

    Article  CAS  PubMed  Google Scholar 

  18. Chen XS, Nie XQ, Chen CM et al (2010) Weekly paclitaxel plus carboplatin is an effective nonanthracycline-containing regimen as neoadjuvant chemotherapy for breast cancer. Ann Oncol 21(5):961–967

    Article  CAS  PubMed  Google Scholar 

  19. Guarneri V, Dieci MV, Bisagni G et al (2015) Preoperative carboplatin-paclitaxel-bevacizumab in triple-negative breast cancer: final results of the phase II Ca.Pa.Be study. Ann Surg Oncol 22(9):2881–2887

    Article  PubMed  Google Scholar 

  20. Yardley DC, R. Conte, P. Brufsky, A. O’Shaughnessy, J. et al (2016) Nab-paclitaxel + carboplatin or gemcitabine vs gemcitabine/carboplatin as first-line treatment for patients with triple-negative metastatic breast cancer: results from the randomized phase 2 portion of the tnAcity trial. In: Presented at: 2016 San Antonio Breast Cancer Symposium, San Antonio. Abstract P5-15-03

  21. Pentheroudakis G, Razis E, Athanassiadis A et al (2006) Paclitaxel-carboplatin combination chemotherapy in advanced breast cancer: accumulating evidence for synergy, efficacy, and safety. Med Oncol 23(2):147–160

    Article  CAS  PubMed  Google Scholar 

  22. Perez EA (2004) Carboplatin in combination therapy for metastatic breast cancer. Oncologist 9(5):518–527

    Article  CAS  PubMed  Google Scholar 

  23. Loesch D, Robert N, Asmar L et al (2002) Phase II multicenter trial of a weekly paclitaxel and carboplatin regimen in patients with advanced breast cancer. J Clin Oncol 20(18):3857–3864

    Article  CAS  PubMed  Google Scholar 

  24. Sutherland S, Miles D, Makris A (2016) Use of maintenance endocrine therapy after chemotherapy in metastatic breast cancer. Eur J Cancer 69:216–222

    Article  CAS  PubMed  Google Scholar 

  25. Dufresne A, Pivot X, Tournigand C et al (2008) Maintenance hormonal treatment improves progression free survival after a first line chemotherapy in patients with metastatic breast cancer. Int J Med Sci 5(2):100–105

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Author notes

  1. Giuseppe Capri and Filippo de Braud contributed equally to this work.

Authors and Affiliations

  1. Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy

    Claudio Vernieri, Monica Milano, Alessia Mennitto, Claudia Maggi, Benvenuto Ferrari, Lucia Rinaldi, Roberta Mennitto, Claudia Stefanetti, Gabriella Mariani, Giulia Bianchi, Giuseppe Capri & Filippo de Braud

  2. Fondazione Istituto FIRC di Oncologia Molecolare (IFOM), Via Adamello 16, Milan, Italy

    Claudio Vernieri

  3. SC Pharmacy, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy

    Barbara Re

  4. Universita’ degli Studi di Milano, Milan, Italy

    Filippo de Braud

Authors
  1. Claudio Vernieri
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  2. Monica Milano
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  3. Alessia Mennitto
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  11. Giulia Bianchi
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  13. Filippo de Braud
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Corresponding author

Correspondence to Claudio Vernieri.

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Vernieri, C., Milano, M., Mennitto, A. et al. Antitumor activity and safety profile of weekly carboplatin plus paclitaxel in metastatic breast cancer: a ten-year, monocentric, retrospective study. Breast Cancer Res Treat 165, 365–373 (2017). https://doi.org/10.1007/s10549-017-4336-z

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  • DOI: https://doi.org/10.1007/s10549-017-4336-z

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