This study, along with a smaller SWOG study, establishes nab-paclitaxel as a legitimate option for triple-negative breast cancer in the neoadjuvant/adjuvant setting.
—Lajos Pusztai, MD
Commenting on the GeparSepto study presented at the San Antonio Breast Cancer Symposium, Lajos Pusztai, MD, Yale University School of Medicine, New Haven, Connecticut, said, “This study, along with a smaller SWOG study, establishes nab-paclitaxel as a legitimate treatment option for triple-negative breast cancer in the neoadjuvant/adjuvant setting.”
“Although more peripheral neuropathy was seen with nab-paclitaxel, it is a classic conundrum for oncologists that more effective cancer therapies are also frequently more toxic,” he noted.
When making individual treatment decisions, Dr. Pusztai said there are two concerns: Should you trade more toxicity for greater efficacy, or should you use nab-paclitaxel at a lower dose? In this instance, lowering the dose may provide a reasonable alternative, he said.
Dr. Pusztai is coauthor of a SWOG study, also presented at SABCS this year, showing that a lower dose of nab-paclitaxel (100 mg/m2 weekly) has fewer side effects while its efficacy seems to be preserved.1
“Also, peripheral neuropathy is cumulative. This toxicity and others can be managed by dose reduction of nab-paclitaxel,” he stated. ■
Disclosure: Dr. Pusztai reported no potential conflicts of interest.
1. Nahleh ZA, et al: 2014 San Antonio Breast Cancer Symposium. Poster P3-11-16. Presented December 11, 2014.