Neurotoxicity as a Prognostic Factor in Patients with Metastatic Breast Cancer Treated with Ixabepilone as a First-Line Therapy

作者：Durando Xavier; Dalenc Florence; Abrial Catherine; Mouret Reynier Marie Ange; Herviou Pauline; Kwiatkowski Fabrice; Chollet Philippe; Roche Henri; Thivat Emilie^*

来源：Oncology, 2015, 88(3): 180-188.

DOI：10.1159/000367808

• Ixabepilone
• Neurotoxicity
• Metastatic breast cancer
• Taxanes

Objective: This study is a longitudinal follow-up of metastatic breast cancer patients treated with ixabepilone as first-line chemotherapy, with the aim to evaluate the association between a mechanism-based neurotoxicity and the efficacy of ixabepilone. Patients and Methods: At the 2 main investigational sites of a phase II clinical trial, 50 patients previously treated with anthracycline received ixabepilone. A chart review was performed to evaluate overall survival (OS) and time to progression (TTP) and to describe the subsequent treatments. Results: The severe neurotoxicity induced by ixabepilone (38%) is correlated with a higher overall response rate to ixabepilone (79 vs. 48%; p = 0.042), a longer TTP (11.4 vs. 6.8 months; p = 0.023) and a longer OS (36.6 vs. 19.9 months; p = 0.05). After ixabepilone discontinuation, patients received a median of 4 subsequent chemotherapy lines (range 1-12). Among the 31 patients who received taxanes, neither the neurotoxicity incidence under treatment with taxanes nor the response was affected by a previous occurrence under ixabepilone treatment. Conclusion: These findings suggest that neurotoxicity development under ixabepilone treatment is a predictor of treatment outcomes as well as a favorable prognostic factor. It highlights the risk-to-benefit ratio issue of ixabepilone. We noticed the possibility to treat patients with taxanes after ixabepilone without systematic recurrent neurotoxicity.

• 出版日期2015