scholarly journals Cisplatin given at three divided doses for three consecutive days in metastatic breast cancer: An alternative schedule for one full dose with comparable efficacy but less CINV and hypomagnesaemia

2019 ◽  
Vol 30 ◽  
pp. v131
Author(s):  
Y. Chen ◽  
J. Zhang ◽  
J. Zhang ◽  
X. Hu
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Metastatic Breast ◽  
Comparable Efficacy ◽  
Full Dose ◽  
Alternative Schedule

The introduction of a third CDK4/6 inhibitor does not change the cost-effectiveness profile in first and subsequent-lines after progression or relapse during previous endocrine therapy in patients with hormone receptor positive (HR+)/human epidermal receptor-2 negative (HER-2) advanced or metastatic breast cancer

2020 ◽  
Vol 26 (6) ◽  
pp. 1486-1491
Author(s):  
Jacopo Giuliani ◽  
Andrea Bonetti
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Dose Reduction ◽  
Endocrine Therapy ◽  
Hormone Receptor ◽  
Metastatic Breast ◽  
Phase Iii ◽  
Full Dose ◽  
Hormone Receptor Positive ◽  
Human Epidermal Receptor

The aim of this study was to assess the pharmacological costs of CDK4/6-inhibitors (palbociclib, ribociclib and abemaciclib) in hormone receptor positive (HR+)/human epidermal receptor 2-negative (HER2-) advanced or metastatic breast cancer (BC). We have considered pivotal phase III randomized controlled trials (RCTs) of palbociclib, ribociclib and abemaciclib for the treatment of postmenopausal women with HR+/HER2- advanced or metastatic BC in first-line in association with letrozole or anastrozole (scenario 1) and in subsequent-lines after progression or relapse during previous endocrine therapy (scenario 2).The costs of drugs are at the Pharmacy of our Hospital and are expressed in euros (€). Six phase III RCTs, including 3843 patients, were considered. In the scenario 1, abemaciclib resulted the less expensive at the full dose, with 2246 € per month of progression free survival (PFS)-gained. Overall ribociclib resulted the less expensive considering the reduction in dosage (36.1% in MONALEESA-2 trial versus (vs). 36.0% of palbociclib in PALOMA-2 trial vs. 43.4% of abemaciclib in MONARCH-3 trial). The price was the same for palbociclib and abemaciclib both at full and with dose reduction. In the scenario 2, the situation was similar to the scenario 1, but with lowest costs for ribociclib per month PFS-gained both at full dose (2070 €) and at dose reduction (1391 € and 690 € at 400 mg and 200 mg, respectively). Combining pharmacological costs of drugs with the measure of efficacy represented by the PFS, ribociclib was the less expensive in both scenarios.

scholarly journals Case Studies in the Management of Metastatic Breast Cancer with Eribulin

2015 ◽  
Vol 9 ◽  
pp. CMO.S27962 ◽  
Author(s):  
Sharon Wilks ◽  
Kristi Mcintyre
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Ductal Carcinoma ◽  
Treatment Options ◽  
Single Agent ◽  
Metastatic Breast ◽  
Eribulin Mesylate ◽  
Full Dose ◽  
Hormone Refractory ◽  
Hands And Feet

Outcomes for triple-negative or hormone-refractory metastatic breast cancer (MBC) are poor and treatment options are limited. Described herein are cases of two women who developed MBC following adjuvant chemotherapy and endocrine therapy for human epidermal growth factor receptor 2 (HER2)-negative ductal carcinoma. Both underwent treatment with fulvestrant, followed by paclitaxel and letrozole or nab-paclitaxel. Following disease progression, both patients started single-agent eribulin mesylate (1.4 mg/m2 on Days 1 and 8 of a 21-day cycle). The first patient is currently continuing on eribulin at full dose, despite interruption for hip surgery and the presence of grade 1 neuropathy in the hands and feet. The second patient had a partial response with eribulin, which was sustained for 4 months. She was able to tolerate the full dose of eribulin despite slight worsening of the neuropathy that was present at baseline. Eribulin may be a beneficial option for hormone-refractory MBC with extensive treatment experience.

scholarly journals Efficacy and Safety of Nanoparticle Albumin-Bound Paclitaxel in Elderly Patients with Metastatic Breast Cancer: A Meta-Analysis

2019 ◽  
Vol 8 (10) ◽  
pp. 1689 ◽  
Author(s):  
Xin Li ◽  
Hyungju Kwon
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Adverse Events ◽  
Elderly Patients ◽  
Meta Analysis ◽  
Metastatic Breast ◽  
Cochrane Library ◽  
Comparable Efficacy ◽  
Efficacy And Safety ◽  
First Line

Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) is an approved treatment for metastatic breast cancer (MBC). However, there is an ongoing debate about the efficacy and safety of nab-paclitaxel in elderly patients. We conducted a meta-analysis to evaluate nab-paclitaxel efficacy and adverse events in MBC patients 65 years and older, compared with MBC patients younger than 65 years (control group). We performed a literature search using PubMed, the Cochrane Library, and EMBASE, from their inception to 30 September 2019. The relevant studies compared overall response rates (ORRs) and incidence of adverse events; four studies comprising 1204 patients were identified and included. ORRs were similar in patients older than 65 years and controls (odds ratio (OR) 0.71, 95% confidence interval (CI) 0.42–1.21). On subgroup analysis, both first-line therapy (OR 2.54, 95% CI 1.92–3.36) and lower Eastern Cooperative Oncology Group (ECOG) performance status (OR 0.20, 95% CI 0.06–0.69) were associated with a higher ORR. Adverse events including neutropenia, sensory neuropathy, diarrhea, and nausea were comparable between the groups. In conclusion, nab-paclitaxel showed comparable efficacy and safety in older and younger patients with MBC. Nab-paclitaxel can be a first-line treatment option for MBC patients 65 years and older.

scholarly journals Comparative study of low dose of capecitabine versus standard dose in metastatic breast cancer: Efficacy and safety

2021 ◽  
Vol 12 (1) ◽  
pp. 12-21
Author(s):  
Engy M Aboelnaga ◽  
Wafaa El-beshbishi
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Standard Dose ◽  
Metastatic Breast ◽  
Comparable Efficacy ◽  
Significant Difference ◽  
Duration Of Response ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background A lower dose of capecitabine revealed better toxicity profiles and comparable efficacy in treatment of metastatic breast cancer (MBC). We aimed to evaluate the efficacy and toxicity of lower dose of capecitabine in comparison with the standard dose. Patients and methods Patients were enrolled in two groups. Group 1 included 21 patients who received the standard dose of capecitabine (1250 mg/m2 twice daily [BID] for 14 days), while the patients in group 2 (19 patients) received lower dose of capecitabine (850 mg/m2 BID for 14 days) every 3 weeks. Results In group 1, dose reduction was reported in 12 (57.1%) patients versus 1 patient in group 2 (5.3%; P = 0.0005). Patients in group 1 reported higher toxicity rates without any significant difference between the groups. The median duration of response was 17 weeks in group 1, while it was 19 weeks in group 2. Disease progression was recorded in 10 (47.6%) patients in group 1 versus 8 (42.1%) patients in group 2 (P = 0.81). The mean time to progression was 8.16 ± 0.63 months and the median was 10.1 months in group 1, while the mean was 8.98 ± 0.75 months and the median was 10 months in group 2 (P = 0.66). The overall survival had a mean of 11.94 ± 0.754 and 11.24 ± 0.665 months, while the median was 13.1 and 13 months in groups 1 and 2, respectively (P = 0.9). Conclusion A lower dose of capecitabine provides MBC patients with an active therapy that can be continued for prolonged periods to achieve long-term disease control without compromising its antitumor activity.

Phase II Parallel Group Study Showing Comparable Efficacy Between Premenopausal Metastatic Breast Cancer Patients Treated With Letrozole Plus Goserelin and Postmenopausal Patients Treated With Letrozole Alone As First-Line Hormone Therapy

2010 ◽  
Vol 28 (16) ◽  
pp. 2705-2711 ◽  
Author(s):  
In Hae Park ◽  
Jungsil Ro ◽  
Keun Seok Lee ◽  
Eun-A Kim ◽  
Youngmee Kwon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Metastatic Breast ◽  
Comparable Efficacy ◽  
Breast Cancer Patients ◽  
Mineral Density ◽  
First Line ◽  
Parallel Group ◽  
Metastatic Setting ◽  
Premenopausal Patients

Purpose Goserelin and letrozole in premenopausal patients can result in clinical outcomes comparable to those obtained by letrozole alone in postmenopausal patients with metastatic breast cancer (MBC). Patients and Methods A total of 73 patients with hormone-responsive MBC were included. Of those, 35 premenopausal patients received goserelin (3.6 mg subcutaneously every 28 days) plus letrozole (2.5 mg orally daily), and 38 postmenopausal patients received letrozole alone as their first-line endocrine therapy in a metastatic setting. Results Baseline characteristics were similar in the two groups, except for a younger age (median, 41 v 53.5 years; P < .001) and a shorter disease-free interval (median, 1.8 v 3.3 years; P = .03) in the premenopausal group. Clinical benefit rates were comparable between the two groups (77% v 74%; P = .77). With the median follow-up of 27.4 months, there was no statistical difference in the median time to progression between the two groups (9.5 months [95% CI, 6.4 to 12.1 months] v 8.9 months [95% CI, 6.4 to 13.3 months]). In patients who did not receive bisphosphonate, letrozole ± goserelin caused a greater loss of bone mineral density at 6 months compared with that of patients receiving bisphosphonate treatment (premenopausal group, −16.7% v 53.9%; P = .002 and postmenopausal group, −13.3% v 17.4%; P = .04 at the lumbar spine). Conclusion Clinical efficacies in premenopausal MBC patients with combined letrozole and goserelin therapy were comparable to those in postmenopausal patients treated with letrozole alone. Although letrozole ± goserelin resulted in a modest increase in bone resorption, concurrent treatment with bisphosphonate could prevent bone loss at 6 months.

scholarly journals Endocrine-Based Treatments in Clinically-Relevant Subgroups of Hormone Receptor-Positive/HER2-Negative Metastatic Breast Cancer: Systematic Review and Meta-Analysis

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1458
Author(s):  
Francesco Schettini ◽  
Mario Giuliano ◽  
Fabiola Giudici ◽  
Benedetta Conte ◽  
Pietro De Placido ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Metastatic Breast Cancer ◽  
Hormone Receptor ◽  
Meta Analysis ◽  
Single Agent ◽  
Metastatic Breast ◽  
Comparable Efficacy ◽  
Second Line ◽  
Hormone Receptor Positive

A precise assessment of the efficacy of first-/second-line endocrine therapies (ET) ± target therapies (TT) in clinically-relevant subgroups of hormone receptor-positive (HR+)/HER2-negative metastatic breast cancer (MBC) has not yet been conducted. To improve our current knowledge and support clinical decision-making, we thus conducted a systematic literature search to identify all first-/second-line phase II/III randomized clinical trials (RCT) of currently approved or most promising ET ± TT. Then, we performed a meta-analysis to assess progression-free (PFS) and/or overall survival (OS) benefit in several clinically-relevant prespecified subgroups. Thirty-five RCT were included (17,595 patients). Pooled results show significant reductions in the risk of relapse or death of 26–41% and 12–27%, respectively, depending on the clinical subgroup. Combination strategies proved to be more effective than single-agent ET (PFS hazard ratio (HR) range for combinations: 0.60–0.65 vs. HR range for single agent ET: 0.59–1.37; OS HR range for combinations: 0.74–0.87 vs. HR range for single agent ET: 0.68–0.98), with CDK4/6-inhibitors(i) + ET being the most effective regimen. Single agent ET showed comparable efficacy with ET+TT combinations in non-visceral (p = 0.63) and endocrine sensitive disease (p = 0.79), while mTORi-based combinations proved to be a valid therapeutic option in endocrine-resistant tumors, as well as PI3Ki + ET in PIK3CA-mutant tumors. These results strengthen international treatment guidelines and can aid therapeutic decision-making.

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