Nab-paclitaxel in the treatment of metastatic breast cancer: A comprehensive review
Department of Medicine, Division of Hematology/Oncology, Sylvester Comprehensive Cancer Center, University of Miami, Leonard M Miller School of Medicine, 1475 NW 12th Avenue, Miami, FL 33136, USA. Expert Review of Clinical Pharmacology
(Impact Factor: 2.18).
05/2011; 4(3):329-34. DOI: 10.1586/ecp.11.7
The novel paclitaxel formulation (nanoparticle albumin-bound [nab] paclitaxel (Abraxane(®)) has recently been approved by the US FDA for treatment of breast cancer after failure of combination chemotherapy for metastatic disease or relapse within 6 months after adjuvant chemotherapy. Apart from its superior efficacy, as demonstrated in the pivotal Phase III study, less toxicity compared with the traditional solvent-containing paclitaxel (Taxol(®)) seems to contribute to its favorable therapeutic index. While approved as a single agent, nab-paclitaxel may prove more effective in combination with either biologic agents and/or other cytotoxic chemotherapeutic agents, as summarized in this article.
Available from: Stefan Gluck
- "Ixabepilone, a semi-synthetic epothilone analog, is indicated as a monotherapy for patients with locally advanced or metastatic breast cancer who have failed an anthracycline, a taxane, and capecitabine and in combination with capecitabine for the treatment of metastatic or locally advanced breast cancer after a failure of an anthracycline and a taxane   . In a phase 2 single-arm study of ixabepilone monotherapy in patients with advanced breast cancer resistant to an anthracycline, a taxane, and capecitabine, independent radiology facility (IRF)-assessed objective response rate (ORR) in all treated patients (n = 126) was 11.1%, 50% of patients achieved SD, 14.3% had SD for ≥6 months, median PFS was 3.1 months, and median OS was 8.6 months  . "
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ABSTRACT: Breast cancer is the most common cancer affecting women worldwide, comprising approximately 20% of all cancers. Although many advances in the treatment of this disease have been made and mortality of early breast cancer improved over the past three decades, metastatic breast cancer (MBC) remains an incurable disease. Cytotoxic chemotherapy continues to play a major role in the treatment of MBC and has been recently combined with biologic agents such as monoclonal antibodies or kinase inhibitors. Over the past decade, several novel cytotoxic chemotherapies have been evaluated in clinical trials. Encouraging results have been observed with novel anti-microtubule agents, with recent US Food and Drug Administration approval of eribulin in 2010. Other novel cytotoxic agents currently under clinical development include novel anti-microtubule drugs, platinum compounds, and anti-angiogenic agents combined with chemotherapy. Here, we review all the major novel cytotoxic agents that have undergone clinical study over the past 5 years for the treatment of MBC.
Available from: Edna Cukierman
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ABSTRACT: Drug and radiation resistance represent a challenge for most anticancer therapies. Diverse experimental approaches have provided evidence that the tumor-associated microenvironment constitutes both a protective shell that impedes drug or radiation access and a permissive or promotive microenvironment that encourages a nurturing cancer (i.e., cancer stem cell) niche where tumor cells overcome treatment- and cancer-induced stresses. Better understanding of the effects of the tumor microenvironment on cancer cells before, during and immediately after chemo- or radiotherapy is imperative to design new therapies aimed at targeting this tumor-protective niche. This review summarizes some of the known mesenchymal stromal effects that account for drug resistance, the main signal transduction pathways associated with this resistance and the therapeutic efforts directed to increase the success of current therapies. Special emphasis is given to environment-mediated drug resistance in general and to cell adhesion-mediated drug resistance in particular.
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