Advancements in the Treatment of Metastatic Breast Cancer (MBC): The Role of Ixabepilone

Table 2

Selected Grade 3 or 4 treatment-related adverse events in advanced, first-line, and neoadjuvant breast cancer settings.

Advanced BC					First-line							Neoadjuvant BC
	Ixa alone		Ixa + C	C	Ixa + Carb + T	Ixa alone	Ixa + B	Ixa + B	P + B	Ixa + C	C	Ixa alone
Reference	[36]	[51]	[38]		[44]	[50]	[41]			[39]		[54]
Patient population	A-, T-, C-resistant	T-resistant	A- and T-resistant		HER2+ confirmed by IHC [3+] or FISH	A-resistant	No prior chemo for MBC			No prior chemo for MBC		No prior chemo/radiation
Patient number	126	49	375	377	39	65	46	45	32	149	144	161
Dose	PI*	PI*	Ixa (PI*) + C: 2000 mg/m^2 on days 1–14 of a 21-day cycle	C: 2500 mg/m^2 on days 1–14 of a 21-day cycle	[A]	PI*	[B]	[C]	[D]	[E]	[F]	PI*, for 4 or fewer cycles
Grade 3/4 hematologic adverse events (%)
Febrile neutropenia	3	10	5	<1	0	6	0	2.2	0	5	1	3
Neutropenia	54	53	68	11	49	58	16	60	22	74	9	14
Grade 3/4 nonhematologic adverse events (%)
PN sensory	14	12^†	21	0	4	20	18	24	25	23	0	1
PN motor	1	0	5	0	0	5	NP	NP	NP			1

[A] Ixa 15 mg/m² IV and carboplatin AUC = 2 IV on days 1, 8, and 15 every 28 days + weekly trastuzumab (4 mg/kg loading dose, then 2 mg/kg IV) during chemotherapy then 6 mg/kg IV every-3-weeks; [B] Ixa 16 mg/m² IV on days 1, 8, and 15 every 28 days + bevacizumab 10 mg/kg IV every 2 weeks; [C] Ixa (per the PI*) + bevacizumab 15 mg/kg IV every 3 weeks; [D] paclitaxel 90 mg/m² IV every 2 weeks + bevacizumab 10 mg/kg IV every 2 weeks; [E] Ixa (per the PI) + oral capecitabine 1000 mg/m² on day 14 every 3 weeks; [F] capecitabine 1250 mg/m² alone on day 14 every 3 weeks.
*The recommended dosage of ixabepilone is 40 mg/m² administered intravenously over 3 hours every 3 weeks. Doses for patients with body surface area greater than 2.2 m² should be calculated based on 2.2 m².
^†Sensory neuropathy was assessed and graded according to symptoms as reported by the patient; neurosensory studies were not performed.
B: bevacizumab; BC: breast cancer; C: capecitabine; Carb: carboplatin; FISH: fluorescent in situ hybridization; IHC: immunohistochemistry; Ixa: Ixabepilone; NP: not provided; MBC: metastatic breast cancer; P: paclitaxel; PI: prescribing information; PN: peripheral neuropathy; T: trastuzumab.