The role of taxanes in triple-negative breast cancer: literature review

Figures & data

Table 1 General characteristics of triple-negative BC^4,5

• Weak association between tumor size and lymph node involvement

• Quick growth and tissular density similar to normal tissue

• High expression of BRCA1 mutation

• High risk of early relapse

• Peak recurrence between the first and third years after diagnosis

• Metastases are rarely preceded by local recurrence

• Higher incidence in younger women, Afro American or Hispanic, and in low socioeconomic conditions

• Stronger association with obesity

• Higher incidence of brain metastases

• Most deaths occur in the first 5 years

• Rapid progression from the onset of metastasis to death

Abbreviation: BC, breast cancer.

Table 2 Taxanes and their combinations recommended by NCCN, ESMO, and AIOM guidelines for triple-negative BC^1,16,17

NCCN^Citation16	ESMO^Citation1	AIOM^Citation17
Monotherapy	Monotherapy (without extensive visceral involvement/symptomatic)	Monotherapy
Paclitaxel Docetaxel Nab-paclitaxel	Weekly paclitaxel Weekly docetaxel or q3w Nab-paclitaxel	Paclitaxel Docetaxel Nab-paclitaxel
Combinations	Combinations (with extensive visceral involvement/symptomatic)	Combinations
Docetaxel + capecitabine Gemcitabine + paclitaxel Paclitaxel + bevacizumab	Anthracycline + taxane (paclitaxel or docetaxel) Docetaxel + capecitabine Paclitaxel + gemcitabine Paclitaxel + vinorelbine Paclitaxel + carboplatin	Anthracycline + taxane (paclitaxel or docetaxel) Docetaxel + capecitabine Paclitaxel + gemcitabine Docetaxel + gemcitabine Paclitaxel + bevacizumab

Abbreviations: AIOM, Associazione Italiana di Oncologia Medica; ESMO, European Society for Medical Oncology; NCCN, National Comprehensive Cancer Network; q3w, every 3 weeks; BC, breast cancer.

Figure 1 Effect of neoadjuvant chemotherapy in data of triple-negative BCs vs non-triple-negative BCs.²³

Notes: ^aP=0.034; ^bP=0.0001; ^cP=0.007.

Abbreviations: Anthra, anthracycline; OS, overall survival; Other, non-triple-negative tumors; pCR, pathological complete response; PFS, progression-free survival.

Figure 2 Efficacy parameters in patients with triple-negative BC treated with nab-paclitaxel/bevacizumab/carboplatin.⁷⁰

Notes: CBR: 95% CI 80–99. ORR: 95% CI 69–95.
Abbreviations: BC, breast cancer; CBR, clinical benefit rate; CI, confidence interval; CR, complete response; ORR, overall response rate; PR, partial response; SD, stable disease.

Figure 3 Pathological Response rate in patients treated with conventional paclitaxel or nab-paclitaxel.⁸⁴

Notes: ypT0ypN0: absence of tumor cells in Tumor and Nodes. ypT0/ispN0: absence of tumor cells in Tumor and Nodes, but in situ cancer cells in the tumor allowed. ypT0/isypN0/+: Absence of tumor cells in Tumor and Nodes, but positive Nodes also allowed.
Abbreviation: pCR, pathological complete response.

Table 3 Sensorial neuropathy (nab-paclitaxel at 125 mg/m²)⁸⁴

	Paclitaxel %	Nab-paclitaxel %	P-value
No neuropathy	57.9	37.7	0.038
Any G toxicity	42.1	62.3	ns
G3/4	5.3	5.7	ns

Abbreviations: G, grade; ns, not significant.

ChacónRDCostanzoMVTriple-negative breast cancerBreast Cancer Res201012Suppl 2S321050424

 PubMed Web of Science ®Google Scholar

HudisCAGianniLTriple-negative breast cancer: an unmet medical needOncologist201116Suppl 1S1S11

 PubMed Web of Science ®Google Scholar

CardosoFHarbeckNFallowfieldLKyriakidesSSenkusEESMO Guidelines Working GroupLocally recurrent or metastatic breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-upAnn Oncol201223Suppl 7vii11vii1922997442

 PubMed Web of Science ®Google Scholar

National Comprehensive Cancer Network (NCCN)Clinical Practice Guidelines in Oncology Breast Cancer version 2.2014Washington, PANational Comprehensive Cancer Network2014

 Google Scholar

Associazione Italiana di Oncologia Medica (AIOM)Linee Guida: Neoplasie della Mammella [Guidelines: Neoplasms of the Breast]MilanAssociazione Italiana di Oncologia Medica2013 Italian

 Google Scholar

LiedtkeCMazouniCHessKRResponse to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancerJ Clin Oncol20082681275128118250347

 PubMed Web of Science ®Google Scholar

GradisharWJKrasnojonDCheporovSSignificantly longer progression-free survival with nab-paclitaxel compared with docetaxel as first-line therapy for metastatic breast cancerJ Clin Oncol200927223611361919470941

 PubMed Web of Science ®Google Scholar

HuangLChenSYaoLLiuGWuJShaoZPhase II trial of weekly nab-paclitaxel and carboplatin treatment with or without trastuzumab as nonanthracycline neoadjuvant chemotherapy for locally advanced breast cancerInt J Nanomedicine2015101969197525792830

 PubMed Web of Science ®Google Scholar