Early-stage TNBC: ixabepilone safer, as effective as paclitaxel

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Takeaway
  • In patients with early-stage triple-negative breast cancer (TNBC), the microtubule stabilizer ixabepilone (Ixempra) is safer and as effective as paclitaxel (Taxol) in combination with AC (doxorubicin [Adriamycin]/cyclophosphamide [Cytoxan]).
Why this matters
  • Ixabepilone offers a treatment alternative to paclitaxel for early-stage TNBC.
Study design
  • This was a phase 3 randomized controlled trial in which 614 patients who completed surgery were randomly assigned to 4 cycles of AC followed by either 4 cycles of ixabepilone (n=306) or paclitaxel (n=308).
  • Patients were followed for a median of 48 mo.
  • Funding: Bristol-Myers Squibb.
Key results
  • Ixabepilone had similar 5-y DFS (87.1%; 95% CI, 82.6%-90.5%) as paclitaxel (84.7%; 95% CI, 79.7%-88.6%).
  • Ixabepilone had similar 5-y OS (89.7%; 95% CI, 85.5%-92.7%) as paclitaxel (89.6%; 95% CI, 85.0%-92.9%).
  • Paclitaxel had more frequent treatment discontinuation, dose modifications, and overall peripheral neuropathy.
Limitations
  • None identified.