PMID- 32776291 OWN - NLM STAT- MEDLINE DCOM- 20210623 LR - 20210623 IS - 1573-7217 (Electronic) IS - 0167-6806 (Linking) VI - 184 IP - 2 DP - 2020 Nov TI - Efficacy and safety analysis of paclitaxel, docetaxel and liposomal paclitaxel after neoadjuvant therapy in breast cancer. PG - 397-405 LID - 10.1007/s10549-020-05851-8 [doi] AB - BACKGROUND AND PURPOSE: Paclitaxel-based regimens are widely used in the neoadjuvant therapy (NAT) of breast cancer. The purpose is to analysis the efficacy and adverse events (AEs) among common paclitaxel (PTX), docetaxel and liposomal paclitaxel. At the same time, we want to analysis the axillary nodal pathologic complete response (apCR) after NAT among the three groups. METHODS: From April 2014 to 2020, 647 breast cancer patients underwent operation after NAT were included in this study. Patients received full course of anthracycline- and paclitaxel-based chemotherapy before surgery. The paclitaxel-based regimens included PTX, docetaxel and liposomal paclitaxel. The therapy efficacy and AEs of the three groups were evaluated. At the same time, the apCR was also analyzed. RESULTS: In general, 30.6% (198/647) of patients achieved breast pathologic complete response (bpCR), which was 28.6%, 28.3% and 39.3% among PTX, docetaxel and liposomal paclitaxel group, respectively (p = 0.067). The total pathologic complete response (tpCR) (achieving both bpCR and apCR) was 21.6% (140/647). The tpCR was 13.3%, 19.4% and 34.4% among PTX, docetaxel and liposomal paclitaxel group, respectively (p = 0.026). The multivariate logistic analysis result showed that clinical tumor stage and molecular subtype were significantly associated with tpCR (all p < 0.05). Among 592 clinical positive patients (cN(+)), the apCR was 39.0% (231/592). The multivariate logistic analysis showed that paclitaxel- based regimens and molecular subtype were indicated as independent predictors for apCR of NAT. The apCR was significantly higher in liposomal paclitaxel group (63.5%) than in PTX (24.6%) and docetaxel group (34.8%) (p < 0.001). The subgroup analysis among different molecular subtypes found that in triple negative (TN) and HER-2 positive (HER2+) subgroup, the apCR in liposomal paclitaxel group was significantly higher than those in PTX and docetaxel group (all p < 0.05). But no significant result was found in the subgroup analysis in hormone receptor positive/HER-2 negative subgroup (p = 0.050). Safety analysis indicated that the incidence of neutropenia (grade III-IV) and peripheral neurotoxicity (grade I-II) was significantly lower in the liposomal paclitaxel group than in the PTX and docetaxel group. The incidence of oral mucositis, anaphylaxis and palmar-plantar erythrodysesthesia syndrome was also much lower in liposomal paclitaxel than other two groups (all p < 0.05). And there was no significant difference in other AEs among the three groups (all p > 0.05). CONCLUSION: Liposome paclitaxel had similar tumor suppressor effect compared with PTX and docetaxel in NAT setting. Moreover, it had a better axillary lymph node (ALN) response after NAT than PTX and docetaxel. These patients who received liposome paclitaxel had more chance to avoid ALN dissection after NAT. At the same time, the application of liposome enables liposome paclitaxel could significantly reduce AEs caused by chemotherapy. Therefore, we suggested the application of liposome paclitaxel in the NAT setting, especially for cN(+) patients with TN and HER2 + disease. FAU - Bi, Zhao AU - Bi Z AUID- ORCID: 0000-0001-9546-1704 AD - Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China. AD - Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China. FAU - Chen, Peng AU - Chen P AD - Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China. AD - Shandong University, Jinan, Shandong, People's Republic of China. FAU - Liu, Yan-Bing AU - Liu YB AD - Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China. FAU - Zhao, Tong AU - Zhao T AD - Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China. FAU - Sun, Xiao AU - Sun X AD - Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China. FAU - Song, Xian-Rang AU - Song XR AD - Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China. sxr@163.vip.com. FAU - Wang, Yong-Sheng AU - Wang YS AD - Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, People's Republic of China. wangysh2008@aliyun.com. LA - eng GR - 81672638, 81672104/National Natural Science Foundation of China/ GR - 2017CXGC1207, 2019GSF108179, 2019GSF108104/Shandong Provincial Key Research and Development Program/ PT - Journal Article DEP - 20200810 PL - Netherlands TA - Breast Cancer Res Treat JT - Breast cancer research and treatment JID - 8111104 RN - 15H5577CQD (Docetaxel) RN - EC 2.7.10.1 (Receptor, ErbB-2) RN - P88XT4IS4D (Paclitaxel) SB - IM MH - Antineoplastic Combined Chemotherapy Protocols/adverse effects MH - *Breast Neoplasms/drug therapy MH - Docetaxel/adverse effects MH - Female MH - Humans MH - *Neoadjuvant Therapy MH - Paclitaxel/adverse effects MH - Receptor, ErbB-2 OTO - NOTNLM OT - Breast cancer OT - Liposome OT - Neoadjuvant therapy OT - Paclitaxel OT - Pathologic complete response EDAT- 2020/08/11 06:00 MHDA- 2021/06/24 06:00 CRDT- 2020/08/11 06:00 PHST- 2020/04/30 00:00 [received] PHST- 2020/07/31 00:00 [accepted] PHST- 2020/08/11 06:00 [pubmed] PHST- 2021/06/24 06:00 [medline] PHST- 2020/08/11 06:00 [entrez] AID - 10.1007/s10549-020-05851-8 [pii] AID - 10.1007/s10549-020-05851-8 [doi] PST - ppublish SO - Breast Cancer Res Treat. 2020 Nov;184(2):397-405. doi: 10.1007/s10549-020-05851-8. Epub 2020 Aug 10.