Taxanes are commonly used as a standard of care treatment for 1L mTNBC. Few studies have directly compared the effectiveness of nab-paclitaxel and paclitaxel in the real world setting, however. This study investigated the overall survival (OS) of nab-paclitaxel vs. paclitaxel as monotherapy in 1L treatment of mTNBC in routine practice.
A total of 200 patients in the Flatiron Health EHR-derived database were included based on a confirmed diagnosis of mTNBC from 1 Jan 2011 and 31 October 2016 and receipt of nab-paclitaxel or paclitaxel monotherapy as 1L treatment. The primary outcome, OS, was estimated by Kaplan-Meier methods and compared by the log-rank test and by univariate and multivariate Cox regression models. Time to next treatment (TTNT) was assessed as a secondary outcome.
Compared with pts who received paclitaxel (n = 95), at baseline, those who received nab-paclitaxel (n = 105) were more likely to have been diagnosed at an earlier stage (I-III), have a treatment free ≤ 12 months (in pts with recurrent disease), adjuvant treatment with a taxane, a prior diagnosis of neuropathy and coverage by commercial healthcare insurance. Other characteristics were balanced between groups. Over 90% of pts with evaluable dosing data (179 of 195) received weekly doses of either taxane, with 100 mg/m2 as the most common dose for nab-paclitaxel and 80 mg/m2 for paclitaxel. Median OS was 11.2 months in pts treated with nab-paclitaxel and 10.8 months in paclitaxel-treated pts (log-rank P = 0.82). The OS hazard ratio (HR) from the adjusted Cox model was 0.90 (95% CI: 0.61, 1.32), indicating a similar risk of death between the two groups. The robustness of this result was confirmed in several sensitivity analyses. TTNT for nab-paclitaxel and paclitaxel was 4.7 and 4.3 months (log-rank P = 0.44), respectively, and did not differ in adjusted analyses (HR = 0.95 [95% CI: 0.65, 1.38]).
Nab-paclitaxel and paclitaxel monotherapy demonstrated similar outcomes, suggesting they may be considered interchangeable as 1L treatments for mTNBC.
Clinical trial identification
Legal entity responsible for the study
F. Hoffmann-La Roche AG.
F. Hoffmann-La Roche AG.
Editorial assistance was provided by Health Interactions.
T. Luhn, S. Chui, A. Hsieh, P. Bajaj, W. Hasnain, T.G.N. Ton: Employee: Genentech, Inc. Stocks: Roche. J. Yi: Consulting agreement: AbbVie, Inc. A. Mecke, A. Falgas: Employee and stock owner: Roche. All other authors have declared no conflicts of interest.