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Abraxane Offers More Benefits Than Taxol When Given Before Surgery to Treat Early-Stage Disease

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Abraxane (chemical name: albumin-bound or nab-paclitaxel) is a different form of paclitaxel than Taxol (chemical name: paclitaxel). Both medicines are taxanes, a powerful type of chemotherapy medicine that can stop cancer cells from repairing themselves and making new cells.

Taxol uses a solvent to dissolve its main ingredients so the medicine can enter the bloodstream. These solvents can make Taxol harder to tolerate while being given. Usually women take medicine before receiving Taxol to minimize any reactions to the solvents. Abraxane doesn’t use a solvent, which can make it easier to tolerate and also means that women don’t need to take medicine before receiving it.

Earlier research has shown that Abraxane offers more benefits than a solvent-based taxane when treating metastatic breast cancer. Another study found that treating early-stage breast cancer before surgery with chemotherapy consisting of a taxane followed by an anthracycline offered better pathologic complete response rates than an anthracycline followed by a taxane.

Treatment given to weaken and destroy breast cancer before surgery is called neoadjuvant treatment. Neoadjuvant chemotherapy isn’t routinely used to treat early-stage breast cancer, but may be used if the cancer is large or aggressive.

One way for doctors to judge the effectiveness of neoadjuvant treatment is to look at the tissue removed during surgery to see if any active cancer cells are present. If no active cancer cells are present, doctors call it a “pathologic complete response.”

Anthracycline chemotherapy medicines are:

  • Adriamycin (chemical name: doxorubicin)
  • Ellence (chemical name: epirubicin)
  • Doxil (chemical name: doxorubicin)
  • daunorubicin (brand names: Cerubidine, DaunoXome)
  • mitoxantrone (brand name: Novantrone)

Anthracyclines work by damaging cancer cells’ genes and interfering with their reproduction.

Because of the earlier studies, the researchers who did this study, called the GeparSepto study, wondered if using Abraxane as the taxane in a taxane-anthracycline neoadjuvant chemotherapy regimen for early-stage breast cancer would have higher pathologic complete response rates than using Taxol as the taxane.

The research was presented at the 2014 San Antonio Breast Cancer Symposium.

In the study, the researchers randomly assigned 1,204 women diagnosed with early-stage breast cancer to receive one of two chemotherapy regimens before surgery:

  • Abraxane once a week for 12 weeks, followed by 12 weeks of Ellence and Cytoxan (chemical name: cyclophosphamide)
  • Taxol one a week for 12 weeks, followed by 12 weeks of Ellence and Cytoxan

The results showed that Abraxane offered a pathologic complete response rate of 38% compared to a pathologic complete response rate of 29% for Taxol.

Like all chemotherapy medicines, taxanes and anthracyclines may cause side effects, some of them serious. Anthracyclines may cause heart damage, which can lead to heart failure. Taxanes may cause low white blood cell counts (neutropenia), weakness, and infection.

Women in the Abraxane treatment group had higher rates of two serious side effects:

  • 92.4% of women getting Abraxane had anemia (low red blood cell counts) compared to 88.3% of women getting Taxol
  • 87.3% of women getting Abraxane had neutropenia compared to 81.5% of women getting Taxol

The most common less serious side effects in both treatment groups were:

  • fatigue
  • diarrhea
  • rash
  • hand-foot syndrome
  • neuropathy
  • muscle pain

More women in the Abraxane treatment group had these less serious side effects than women in the Taxol treatment group.

More women being treated with Abraxane stopped treatment because of side effects compared to women being treated with Taxol.

If you’ve been diagnosed with early-stage breast cancer and your doctor recommends that you have chemotherapy before surgery, you may want to talk to your doctor about this study and ask if using Abraxane instead of Taxol in your chemotherapy regimen makes sense for you. Together, you and your doctor will make the best decision for your unique situation.

For more information, including what to expect when receiving chemotherapy, visit the Chemotherapy section.

Read more news from the 2014 San Antonio Breast Cancer Symposium:

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