1891 - Real-world comparative effectiveness analysis of second-line (2L) nab-paclitaxel (nab-P) vs paclitaxel (Pac) in patients (Pts) with metastatic breast cancer (MBC)

Background

nab-P monotherapy is approved for 2L treatment (Tx) of MBC. This real-world analysis evaluated comparative effectiveness of 2L nab-P vs Pac in pts with MBC.

Methods

A retrospective cohort study was performed using fully de-identified data from a US electronic medical record platform of 1300 community (non-university based) oncologists. This analysis included pts with MBC who initiated 2L nab-P or Pac monotherapy from 12/1/10 to 4/6/15 (≥ 2 doses of nab-P or Pac required to be included in the analysis). The primary objectives were time to Tx discontinuation (TTD) and time to next Tx (TTNT). Adverse events (AEs) and supportive care were also examined. Subanalyses in pts with hormone receptor–positive (HR+)/human epidermal growth factor receptor 2–negative (HER2−) or triple-negative (TN) MBC were conducted.

Results

This analysis included 411 pts (109 treated with nab-P Tx and 302 with Pac Tx). Pts treated with nab-P were older (mean 61 vs 57 y) and more frequently had HR+ (78% vs 65%) or HER2− (83% vs 70%) disease. Most pts received weekly Tx (Table). Prior use of a taxane or concurrent use of a targeted agent was similar between groups. nab-P was associated with significantly longer TTD vs Pac. TTNT was similar between groups. Pts treated with nab-P had less fatigue, pain, and neuropathy but more nausea and vomiting vs Pac. Antiemetics (IV) and Tx for hydration and allergic reaction were used less with nab-P, and Tx for bone loss and granulocyte colony-stimulating factor (G-CSF) were used less with Pac. In subgroup analyses, TTD was significantly longer with nab-P vs Pac in pts with HR + /HER2− or TN MBC, and TTNT was numerically longer with nab-P vs Pac in pts with HR + /HER2− MBC.