by C.H. Weaver M.D. updated 12/2022
Abraxane is a standard treatment for advanced breast cancers including triple negative breast cancer (TNBC). Approximately 10-20% of breast cancers are referred to as TNBC. These cancers are both hormone receptor-negative and HER2-negative.
Hormone-negative breast cancer refers to a type of breast cancer that is both estrogen- and progesterone-receptor negative. This means that this type of cancer is not stimulated to grow from exposure to the female hormones estrogen and/or progesterone. About one-third or fewer breast cancers are hormone-negative.
Approximately 25-30% of breast cancers are referred to as human epidermal growth factor receptor (HER)2-positive, in which the cancer cells have a gene mutation that causes extra HER2 receptors to be present on the cell surface. HER2-negative breast cancer refers to cancer that does not have a mutated HER2 pathway, and therefore, is not stimulated to replicate and spread through the activity of excessive HER2 receptors.
Many treatments are available specifically for hormone-positive breast cancers, as well as HER2-breast cancers. Since these treatments are ineffective in TNBC, research efforts are underway to find new treatment options or optimal combinations of agents TNBC.
Tecentriq (atezolizumb) when administered in addition to the chemotherapy agent, Abraxane (nab-paclitaxel), provides high anti-cancer responses among patients with TNBC. Tecentriq is a checkpoint inhibitor – t helps the immune system recognize cancer cells as a threat, so that an immune attack is initiated against the cancer.
A recent trial included women with advanced TNBC.
- Anti-cancer responses with Tecentriq/Abraxane were achieved 71% of patients.
- Among patients who had not received prior therapy for advanced TNBC, anti-cancer responses with were achieved in nearly 89% of patients.
- Serious side effects were not increased with the addition of Tecentriq to Abraxane, when compared to prior results of patients treated with Abraxane alone.
The researchers concluded that the treatment combination consisting of Tecentiq plus Abraxane provides high anti-cancer responses among women with advanced TNBC.
Neoadjuvant Abraxane + Carboplatinum
The chemotherapy combination consisting of Abraxane® (nab-paclitaxel) plus carboplatinum (carbo) improves outcomes compared with Abraxane plus Gemzar (gemcitabine) for triple negative breast cancer.
Researchers have compared two different chemotherapy regimens for the treatment of TNBC in the ADAPT trial. The trial included 336 patients from 47 different medical centers with early TNBC. One group of patients was treated with Abraxane plus carboplatinum and the other group was treated with Abraxane plus gemcitabine prior to surgery. Patients were treated with the chemotherapy for 2 cycles consisting of 12 weeks.2
- A pathologic complete remission (pCR) was achieved in 47% of patients treated with Abraxane/Carbo compared with only 27% among patients treated with Abraxane/gemcitabine.
The researchers stated that “the results suggest superior efficacy and excellent toxicity of Abraxane/Carbo.” Importantly, these treatment regimens did not include the chemotherapy agents referred to as anthracyclines, which are associated with significant side effects, and continue to identify optimal treatment regimens for TNBC.
References:
- Adams S, et al. Safety and clinical activity of atezolizumab (anti-PD-L1) in combination with nab-paclitaxel in patients with triple-negative breast cancer. Proceedings from the 2015 annual San Antonio Breast Cancer Symposium. Presented December 10, 2015. Abstract number: 850477.
- Gluz O, Nitz U, Liedtke C, et al. Comparison of 12 weeks neoadjuvant Nab-paclitaxel combined with carboplatinum vs. gemcitabine in triple- negative breast cancer: WSG-ADAPT TN randomized phase II trial. Proceedings from the 2015 annual San Antonio Breast Cancer Symposium. Abstract S6-07.
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