Taxanes in the elderly patient with metastatic breast cancer

Figures & data

Table 1 Efficacy of taxanes in elderly patients

	n	Treatment	Line of therapy	PS	Age in years, median	ORR (%)	OS in months (median)
sb-P
ten Tije et al^Citation38	23	sb-P 80 mg/m^2 qw 3/4	First	0–2	77	38	NR
Del Mastro et al^Citation39	41	sb-P 80 mg/m^2 qw 3/4	First	0–2	74	54	35.8
Beuselinck et al^Citation37	28	sb-P 80 mg/m^2 qw	≥ First	0–2	75–76a	50	NR
		D 36 mg/m^2 qw				25
Lichtman et al^Citation36,b	271	sb-P 80 mg/m^2 qw; sb-P 175–250 mg/m^2 q3w	First or second	0–2	≥65	35/24c	NR
D
Hainsworth et al^Citation43	36	D 36 mg/m^2 qw 6/8	First or second	0–2	74d	36	13
D’hondt et al^Citation44	37	D 36 mg/m^2 qw 6/7 → qw 2/3 or qw 3/4	≥ First	0–3	63	30	6.5
Maisano et al^Citation45	21	D 35 mg/m^2 qw 6/8 → qw 3/4	First	0–2	≥ 70	33	NR
Lorenzo et al^Citation46	28	D 50–100 mg/m^2 q3w or q4w	First or second	0–2	72	50	26.6
Massacesi et al^Citation47	33	D 25–30 mg/m^2 qw, 40–50 mg/m^2 q2w, or 75–100 mg/m^2 q3w	. First	0–.2	70	24	16
Pivot et al^Citation42,b		D 100 mg/m^2 q3w	First	0–1			NR
	38	+ placebo			67	45
	41	+ bev 7.5 mg/kg			69	37
	48	+ bev 15 mg/kg			68	50
nab-P
Aapro et al^Citation50,b	30	nab-P 260 mg/m^2 q3w	≥ First	0–2	70	27	17.6
	32	sb-P 175 mg/m^2 q3w			69	19	12.8
	9	nab-P 300 mg/m^2 q3w	First	0–2	67	22	19.9
	14	nab-P 100 mg/m^2 qw 3/4			69	64	21.7
	10	nab-P 150 mg/m^2 qw 3/4			67	60	20.7
	19	D 100 mg/m^2 q3w			69	32	21.2

Notes:

a Mean of trial-enrolled patients aged ≥70 years or considered frail;

b retrospective analysis;

c around 35% in first line and 24% in second line;

d patients were either aged >65 years or considered poor candidates for combination chemotherapy.

Abbreviations: bev, bevacizumab; D, docetaxel; nab, nanoparticle albumin-bound; NR, not reported; ORR, overall response rate; OS, overall survival; P, paclitaxel; PS, performance status; q2w, every 2 weeks; q3w, every 3 weeks; q4w, every 4 weeks; qw, weekly; qw 2/3, the first 2 of 3 weeks; qw 3/4, the first 3 of 4 weeks; qw 6/7, the first 6 of 7 weeks; qw 6/8, the first 6 of 8 weeks; sb, solvent-based.

Table 2 Safety of taxanes in elderly patients

	n	Treatment	Grade ≥3 adverse events (%)
			Neutropenia	Fatigue	Sensory neuropathy
sb-P
ten Tije et al^Citation38	26	sb-P 80 mg/m^2 qw 3/4	12	4	4a
Del Mastro et al^Citation39	46	sb-P 80 mg/m^2 qw 3/4	9	4	2
Beuselinck et al^Citation37	33b	sb-P 80 mg/m^2 qw	45	6	9
	37b	D 36 mg/m^2 qw	19	8	3
Lichtman et al^Citation36,c	270	sb-P 80 mg/m^2 qw; sb-P 175–250 mg/m^2 q3w	NR	10d	28
D
Hainsworth et al^Citation43	41	D 36 mg/m^2 qw 6/8	2e	20	0
D’hondt et al^Citation44	47	D 36 mg/m^2 qw 6/7 → qw 2/3 or qw 3/4	21	0	0
Maisano et al^Citation45	21	D 35 mg/m^2 qw 6/8 → qw 3/4	5	10f	NR
Lorenzo et al^Citation46	28	D 50–100 mg/m^2 q3-4w	18	7f	4
Massacesi et al^Citation47	37	D 25–30 mg/m^2 qw, 40–50 mg/m^2 q2w, or 75–100 mg/m^2 q3w	14	22f	0
Pivot et al^Citation42,c		D 100 mg/m^2 q3w		NR	NR
	38	+ placebo	19
	41	+ bev 7.5 mg/kg	27
	48	+ bev 15 mg/kg	33
nab-P
Aapro et al^Citation50,c	30	nab-P 260 mg/m^2 q3w	33	10	17
	32	sb-P 175 mg/m^2 q3w	66	6	0
	9	nab-P 300 mg/m^2 q3w	67	0	11
	14	nab-P 100 mg/m^2 qw 3/4	36	14	21
	10	nab-P 150 mg/m^2 qw 3/4	50	10	20
	19	D 100 mg/m^2 q3w	84	32	16

Notes:

a Reported as neuropathy;

b percentages based on the entire elderly/frail population (elderly-specific data not given);

c retrospective analysis;

d reported as malaise;

e reported as neutropenia/fever;

f reported as asthenia.

Abbreviations: bev, bevacizumab; D, docetaxel; nab, nanoparticle albumin-bound; NR, not reported; P, paclitaxel; q2w, every 2 weeks; q3w, every 3 weeks; qw, weekly; qw 2/3, the first 2 of 3 weeks; qw 3/4, the first 3 of 4 weeks; qw 6/7, the first 6 of 7 weeks; qw 6/8, the first 6 of 8 weeks; sb, solvent-based.

ten TijeAJSmorenburgCHSeynaeveCWeekly paclitaxel as first-line chemotherapy for elderly patients with metastatic breast cancer. A multicentre phase II trialEur J Cancer200440335235714746852

 PubMed Web of Science ®Google Scholar

Del MastroLPerroneFRepettoLWeekly paclitaxel as first-line chemotherapy in elderly advanced breast cancer patients: a phase II study of the Gruppo Italiano di Oncologia Geriatrica (GIOGer)Ann Oncol200516225325815668279

 PubMed Web of Science ®Google Scholar

BeuselinckBWildiersHWynendaeleWDirixLKainsJPParidaensRWeekly paclitaxel versus weekly docetaxel in elderly or frail patients with metastatic breast carcinoma: a randomized phase-II study of the Belgian Society of Medical OncologyCrit Rev Oncol Hematol2010751707719651523

 PubMed Web of Science ®Google Scholar

LichtmanSMHurriaACirrincioneCTPaclitaxel efficacy and toxicity in older women with metastatic breast cancer: combined analysis of CALGB 9342 and 9840Ann Oncol201223363263821693770

 PubMed Web of Science ®Google Scholar

HainsworthJDBurrisHA3rdYardleyDAWeekly docetaxel in the treatment of elderly patients with advanced breast cancer: a Minnie Pearl Cancer Research Network phase II trialJ Clin Oncol200119153500350511481356

 PubMed Web of Science ®Google Scholar

D’hondtRParidaensRWildiersHSafety and efficacy of weekly docetaxel in frail and/or elderly patients with metastatic breast cancer: a phase II studyAnticancer Drugs200415434134615057137

 PubMed Web of Science ®Google Scholar

MaisanoRMareMCaristiNA modified weekly docetaxel schedule as first-line chemotherapy in elderly metastatic breast cancer: a safety studyJ Chemother200517224224615920913

 PubMed Web of Science ®Google Scholar

LorenzoIConstenlaMPalaciosPDocetaxel as single-agent treatment in elderly patients with advanced breast cancerClin Drug Investig2005254249256

 PubMed Web of Science ®Google Scholar

MassacesiCMarcucciFBoccettiTLow dose-intensity docetaxel in the treatment of pre-treated elderly patients with metastatic breast cancerJ Exp Clin Cancer Res2005241434815943030

 PubMed Web of Science ®Google Scholar

PivotXSchneeweissAVermaSEfficacy and safety of bevacizumab in combination with docetaxel for the first-line treatment of elderly patients with locally recurrent or metastatic breast cancer: results from AVADOEur J Cancer201147162387239521757334

 PubMed Web of Science ®Google Scholar

AaproMTjulandinSBharPGradisharWWeekly nab-paclitaxel is safe and effective in >/=65 years old patients with metastatic breast cancer: a post-hoc analysisBreast201120546847421843943

 PubMed Web of Science ®Google Scholar