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.
Reference
1. Nahleh ZA, et al: 2014 San Antonio Breast Cancer Symposium. Poster P3-11-16. Presented December 11, 2014.
