epothilone-a and Carcinoma--Ductal--Breast

Triple negative breast cancer (TNBC) is associated with high pathological complete remission (pCR) rate in neoadjuvant treatment (NAT). TNBC patients who achieve pCR have superior outcome than those without pCR. A meta-analysis was done to evaluate whether integrating novel approaches into NAT can improve the pCR rate in TNBC. Medical subject heading terms (Breast Neoplasm) and key words (triple negative OR estrogen receptor (ER) negative OR HER2 negative) AND (primary systemic OR neoadjuvant OR preoperative) were used to select eligible studies. Experimental arm in each study was considered as the testing regimen, and control arm was defined as the standard regimen in this meta-analysis. A total of 11 studies with 14 paired regimens were included in the final analysis. Aggregate pCR rate was 37.3% and 44.6% in the standard and testing group, respectively. Novel approaches in the testing regimen significantly improved the pCR rate in NAT of TNBC patients compared with the standard regimen, with an odds ratio (OR) of 1.34 (95% confidence interval (CI) 1.11-1.62, P = 0.002). Considering specific regimens, we demonstrated the pCR rate to be much higher in the carboplatin-containing (OR = 1.80, 95% CI 1.39-2.32, P<0.001) or bevacizumab-containing regimens (OR = 1.36, 95% CI 1.11-1.66, P = 0.003) than in the control regimens. The addition of carboplatin in NAT had a pCR rate as high as 51.2% in TNBC patients, with an absolute pCR difference of 13.8% as compared with control regimens. No significant heterogeneity was identified among studies evaluating the addition of carboplatin or bevacizumab efficacy in NAT. This meta-analysis indicates that these novel NAT regimens have achieved a significant pCR improvement in TNBC patients, especially among patients treated with carboplatin-containing or bevacizumab-containing regimen. This can help us design appropriate trials in the adjuvant setting and guide clinical practice.

Topics: Anthracyclines; Antineoplastic Combined Chemotherapy Protocols; Bevacizumab; Capecitabine; Carboplatin; Carcinoma, Ductal, Breast; Deoxycytidine; Epothilones; Female; Gemcitabine; Humans; Mastectomy; Multicenter Studies as Topic; Neoadjuvant Therapy; Randomized Controlled Trials as Topic; Remission Induction; Taxoids; Treatment Outcome; Triple Negative Breast Neoplasms

Radiation recall dermatitis (RRD) is an inflammatory reaction occurring in a previously irradiated area, precipitated by the administration of certain drugs. The drugs most commonly associated with RRD are intravenous antineoplastic agents. The frequency of development of this toxicity in clinical practice is unclear. We report a case of RRD induced by ixabepilone, an epothilone antineoplastic agent, with successful rechallenge utilizing an alternative dosing regimen.

Topics: Adult; Antibodies, Monoclonal, Humanized; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Breast Neoplasms; Carcinoma, Ductal, Breast; Combined Modality Therapy; Drug Administration Schedule; Drug Monitoring; Drug Resistance, Neoplasm; Epothilones; Female; Humans; Lymphatic Metastasis; Neoplasm Recurrence, Local; Radiodermatitis; Trastuzumab; Treatment Outcome; Tubulin Modulators