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Research Article

Nanoparticle albumin-bound paclitaxel is superior to liposomal paclitaxel in the neoadjuvant treatment of breast cancer

    Weiwei Zhang‡

    Department of Breast Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210000, China

    ‡Authors contributed equally

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    ,
    Yinggang Xu‡

    Department of Breast Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210000, China

    ‡Authors contributed equally

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    ,
    Xiaoqing Shi

    Department of Breast Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210000, China

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    ,
    Xiaofeng Huang

    Department of Breast Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210000, China

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    ,
    Rui Chen

    Department of Breast Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210000, China

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    ,
    Haiping Xu

    Department of Nursing, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210000, China

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    ,
    Wenjie Shi

    Department of Breast Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210000, China

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    ,
    Xinyu Wan

    Department of Breast Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210000, China

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    ,
    Ye Wang

    Department of Breast Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210000, China

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    ,
    Jinzhi He

    Department of Breast Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210000, China

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    ,
    Cuiying Li

    Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210000, China

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    ,
    Jue Wang

    *Author for correspondence:

    E-mail Address: wangjue200011@163.com

    Department of Breast Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210000, China

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    &
    Xiaoming Zha

    **Author for correspondence:

    E-mail Address: njzhaxm@njmu.edu.cn

    Department of Breast Disease, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210000, China

    Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, Jiangsu, 210000, China

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    Published Online:8 Apr 2022https://doi.org/10.2217/nnm-2022-0025

    Abstract

    Aim: The present study aimed to retrospectively compare the efficacy and safety between liposomal paclitaxel (Lps-P) and nanoparticle albumin-bound paclitaxel (Nab-P) in neoadjuvant systemic treatment (NST) of breast cancer. Materials & methods: Two hundred thirty-five patients who were diagnosed with invasive breast cancer and then received dose-dense NST with epirubicin and cyclophosphamide followed by paclitaxel were enrolled. Results: Nab-P has an advantage in improving the total and axillary-only pathologic complete response rate over Lps-P. Although Nab-P can cause a higher incidence and severity of peripheral sensory neuropathy (PSN), most symptoms are temporary and reversible. In the Lps-P group, the proportion of patients with residual irreversible PSN is larger. Conclusion: Nab-P might be superior to Lps-P in NST of breast cancer.

    Plain language summary

    Neoadjuvant systemic treatment (NST) is recommended for many patients with breast cancer before they undergo surgery to remove the cancer. This study retrospectively compared the efficacy and safety of two potential NST drugs, liposomal paclitaxel (Lps-P) and nanoparticle albumin-bound paclitaxel (Nab-P). Two hundred thirty-five patients participated in the study. These patients had been diagnosed with invasive breast cancer and were recommended NST with paclitaxel before surgery. The results showed that more participants who received Nab-P had no signs of cancer in their tissue samples from their breasts and armpit lymph nodes than participants who received Lps-P. Although Nab-P can cause a higher incidence and severity of peripheral sensory neuropathy (PSN), most symptoms are temporary and reversible. In conclusion, Nab-P might be superior to Lps-P for NST.

    Papers of special note have been highlighted as: • of interest

    References

    • 1. Britt KL, Cuzick J, Phillips KA. Key steps for effective breast cancer prevention. Nat. Rev. Cancer 20(8), 417–436 (2020).
      Medline CASGoogle Scholar
    • 2. Von Minckwitz G, Untch M, Blohmer JU et al. Definition and impact of pathologic complete response on prognosis after neoadjuvant chemotherapy in various intrinsic breast cancer subtypes. J. Clin. Oncol. 30(15), 1796–1804 (2012).
      MedlineGoogle Scholar
    • 3. Rastogi P, Anderson SJ, Bear HD et al. Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27. J. Clin. Oncol. 26(5), 778–785 (2008).
      MedlineGoogle Scholar
    • 4. Wani MC, Taylor HL, Wall ME et al. Plant antitumor agents. VI. The isolation and structure of taxol, a novel antileukemic and antitumor agent from Taxus brevifolia. J. Am. Chem. Soc. 93(9), 2325–2327 (1971).
      Medline CASGoogle Scholar
    • 5. Liebmann J, Cook JA, Mitchell JB. Cremophor EL, solvent for paclitaxel, and toxicity. Lancet 342(8884), 1428 (1993).
      Medline CASGoogle Scholar
    • 6. Gelderblom H, Verweij J, Nooter K, Sparreboom A. Cremophor EL: the drawbacks and advantages of vehicle selection for drug formulation. Eur. J. Cancer 37(13), 1590–1598 (2001).
      Medline CASGoogle Scholar
    • 7. Wiernik PH, Schwartz EL, Strauman JJ et al. Phase I clinical and pharmacokinetic study of taxol. Cancer Res. 47(9), 2486–2493 (1987).
      Medline CASGoogle Scholar
    • 8. Koudelka S, Turánek J. Liposomal paclitaxel formulations. J. Control. Release 163(3), 322–334 (2012).
      Medline CASGoogle Scholar
    • 9. Terwogt JM, Nuijen B, Huinink WW, Beijnen JH. Alternative formulations of paclitaxel. Cancer Treat. Rev. 23(2), 87–95 (1997).
      Medline CASGoogle Scholar
    • 10. Cabanes A, Briggs KE, Gokhale PC et al. Comparative in vivo studies with paclitaxel and liposome-encapsulated paclitaxel. Int. J. Oncol. 12(5), 1035–1040 (1998).
      Medline CASGoogle Scholar
    • 11. Zhang Q, Huang XE, Gao LL. A clinical study on the premedication of paclitaxel liposome in the treatment of solid tumors. Biomed. Pharmacother. 63(8), 603–607 (2009).
      Medline CASGoogle Scholar
    • 12. Strieth S, Eichhorn ME, Werner A et al. Paclitaxel encapsulated in cationic liposomes increases tumor microvessel leakiness and improves therapeutic efficacy in combination with cisplatin. Clin. Cancer Res. 14(14), 4603–4611 (2008).
      Medline CASGoogle Scholar
    • 13. Ibrahim NK, Desai N, Legha S et al. Phase I and pharmacokinetic study of ABI-007, a Cremophor-free, protein-stabilized, nanoparticle formulation of paclitaxel. Clin. Cancer Res. 8(5), 1038–1044 (2002).
      Medline CASGoogle Scholar
    • 14. Gradishar WJ. Albumin-bound paclitaxel: a next-generation taxane. Expert Opin. Pharmacother. 7(8), 1041–1053 (2006).
      Medline CASGoogle Scholar
    • 15. Green MR, Manikhas GM, Orlov S et al. Abraxane, a novel Cremophor-free, albumin-bound particle form of paclitaxel for the treatment of advanced non-small-cell lung cancer. Ann. Oncol. 17(8), 1263–1268 (2006).
      Medline CASGoogle Scholar
    • 16. Gianni L, Mansutti M, Anton A et al. Comparing neoadjuvant nab-paclitaxel vs paclitaxel both followed by anthracycline regimens in women with ERBB2/HER2-negative breast cancer – the Evaluating Treatment With Neoadjuvant Abraxane (ETNA) trial: a randomized phase 3 clinical trial. JAMA Oncol. 4(3), 302–308 (2018).
      MedlineGoogle Scholar
    • 17. Untch M, Jackisch C, Schneeweiss A et al. NAB-paclitaxel improves disease-free survival in early breast cancer: GBG 69-GeparSepto. J. Clin. Oncol. 37(25), 2226–2234 (2019). • The phase III trial showed that a significantly higher pathologic complete response rate with Nab-paclitaxel translated into a significantly improved invasive disease free survival in patients with early breast cancer compared with solvent-based paclitaxel.
      Medline CASGoogle Scholar
    • 18. Untch M, Jackisch C, Schneeweiss A et al. Nab-paclitaxel versus solvent-based paclitaxel in neoadjuvant chemotherapy for early breast cancer (GeparSepto-GBG 69): a randomised, phase 3 trial. Lancet Oncol. 17(3), 345–356 (2016). • The phase III trial showed that substituting solvent-based paclitaxel with Nab-paclitaxel significantly increases the proportion of patients achieving a pathological complete response rate after anthracycline-based chemotherapy.
      Medline CASGoogle Scholar
    • 19. Pilewskie M, Morrow M. Axillary Nodal management following neoadjuvant chemotherapy: a review. JAMA Oncol. 3(4), 549–555 (2017). • Indicated that neoadjuvant chemotherapy reduces the need for axillary lymph node dissection, and sentinel lymph node biopsy is an accurate method of determining nodal status after neoadjuvant systemic treatment.
      MedlineGoogle Scholar
    • 20. King TA, Morrow M. Surgical issues in patients with breast cancer receiving neoadjuvant chemotherapy. Nat. Rev. Clin. Oncol. 12(6), 335–343 (2015).
      MedlineGoogle Scholar
    • 21. Samiei S, Van Nijnatten TJA, De Munck L et al. Correlation between pathologic complete response in the breast and absence of axillary lymph node metastases after neoadjuvant systemic therapy. Ann. Surg. 271(3), 574–580 (2020).
      MedlineGoogle Scholar
    • 22. Derks MGM, Van De Velde CJH. Neoadjuvant chemotherapy in breast cancer: more than just downsizing. Lancet Oncol. 19(1), 2–3 (2018).
      MedlineGoogle Scholar
    • 23. Li Y, Chen X, Zhu Q et al. Retrospective comparisons of nanoparticle albumin-bound paclitaxel and docetaxel neoadjuvant regimens for breast cancer. Nanomed. (Lond). 16(5), 391–400 (2021).
      CASGoogle Scholar
    • 24. Xie F, Chen R, Zhang L et al. Efficacy of two-weekly nanoparticle albumin-bound paclitaxel as neoadjuvant chemotherapy for breast cancer. Nanomed. (Lond). 14(12), 1595–1603 (2019).
      CASGoogle Scholar
    • 25. Amin MB, Greene FL, Edge SB et al. The eighth edition AJCC Cancer Staging Manual: continuing to build a bridge from a population-based to a more ‘personalized’ approach to cancer staging. CA Cancer J. Clin. 67(2), 93–99 (2017).
      MedlineGoogle Scholar
    • 26. Citron ML, Berry DA, Cirrincione C et al. Randomized trial of dose-dense versus conventionally scheduled and sequential versus concurrent combination chemotherapy as postoperative adjuvant treatment of node-positive primary breast cancer: first report of Intergroup Trial C9741/Cancer and Leukemia Group B Trial 9741. J. Clin. Oncol. 21(8), 1431–1439 (2003). • The result of the study illustrates that dose density improves clinical outcomes significantly, despite the lower than expected number of events.
      Medline CASGoogle Scholar
    • 27. Del Mastro L, De Placido S, Bruzzi P et al. Fluorouracil and dose-dense chemotherapy in adjuvant treatment of patients with early-stage breast cancer: an open-label, 2 × 2 factorial, randomised phase 3 trial. Lancet 385(9980), 1863–1872 (2015).
      MedlineGoogle Scholar
    • 28. Untch M, Möbus V, Kuhn W et al. Intensive dose-dense compared with conventionally scheduled preoperative chemotherapy for high-risk primary breast cancer. J. Clin. Oncol. 27(18), 2938–2945 (2009).
      MedlineGoogle Scholar
    • 29. Möbus V, Jackisch C, Lück HJ et al. Ten-year results of intense dose-dense chemotherapy show superior survival compared with a conventional schedule in high-risk primary breast cancer: final results of AGO phase III iddEPC trial. Ann. Oncol. 29(1), 178–185 (2018).
      Medline CASGoogle Scholar
    • 30. Ye J, Li R, Yang Y et al. Comparative colloidal stability, antitumor efficacy, and immunosuppressive effect of commercial paclitaxel nanoformulations. J. Nanobiotechnol. 19(1), 199 (2021).
      Medline CASGoogle Scholar
    • 31. Straver ME, Rutgers EJ, Rodenhuis S et al. The relevance of breast cancer subtypes in the outcome of neoadjuvant chemotherapy. Ann. Surg. Oncol. 17(9), 2411–2418 (2010).
      Medline CASGoogle Scholar
    • 32. Disipio T, Rye S, Newman B, Hayes S. Incidence of unilateral arm lymphoedema after breast cancer: a systematic review and meta-analysis. Lancet Oncol. 14(6), 500–515 (2013).
      MedlineGoogle Scholar
    • 33. Gradishar WJ, Krasnojon D, Cheporov S et al. Significantly longer progression-free survival with nab-paclitaxel compared with docetaxel as first-line therapy for metastatic breast cancer. J. Clin. Oncol. 27(22), 3611–3619 (2009). • Recovery from sensory neuropathy occurred more rapidly after treatment with any dose of Nab-paclitaxel compared with docetaxel.
      Medline CASGoogle Scholar
    • 34. Robert N, Krekow L, Stokoe C et al. Adjuvant dose-dense doxorubicin plus cyclophosphamide followed by dose-dense nab-paclitaxel is safe in women with early-stage breast cancer: a pilot study. Breast Cancer Res. Treat. 125(1), 115–120 (2011). • Although grade 2 and 3 peripheral neuropathy was common during dose-dense nab-paclitaxel treatment, it was generally transient and improved significantly or resolved in most patients.
      Medline CASGoogle Scholar
    • 35. Gradishar WJ, Tjulandin S, Davidson N et al. Phase III trial of nanoparticle albumin-bound paclitaxel compared with polyethylated castor oil-based paclitaxel in women with breast cancer. J. Clin. Oncol. 23(31), 7794–7803 (2005).
      Medline CASGoogle Scholar