ABSTRACT
Breast cancer is the most common malignant tumor of women, which seriously threatens women's health. Albumin-bound paclitaxel is the basic chemotherapy drug for breast cancer treatment. We can promote reasonable clinical medication and improve patients' quality of life by standardizing chemotherapy plans, rationally optimizing treatment strategy and managing adverse reactions of albumin-bound paclitaxel. In order to standardize the clinical application of albumin-bound paclitaxel in breast cancer, Chinese Medical Doctor Association Oncologist Branch Breast Cancer Group and International Medical Exchange Branch of China Anti-Cancer Association consulted guidelines and the latest evidence-based evidences and formulated Chinese expert consensus of albumin-bound paclitaxel in the treatment of breast cancer to provide reference for clinical diagnosis and treatment of breast cancer. The consensus mainly introduces the clinical application strategies and evidence-based evidences of albumin-bound paclitaxel in advanced therapy, neoadjuvant therapy and adjuvant therapy of breast cancer. Among them, the regimens containing albumin-bound paclitaxel are the better recommended regimens for preoperative neoadjuvant and advanced rescue therapy of breast cancer. However, there is little evidence in adjuvant therapy, so it is recommended to use albumin-bound paclitaxel cautiously. We also invited breast cancer clinical experts to vote on some controversial issues, including but not limited to the usage and dosage of albumin-bound paclitaxel, combined medication and management of peripheral neuropathy, and formed consensus recommendations for the reference of breast cancer clinical workers.
Subject(s)
Female , Humans , Albumin-Bound Paclitaxel/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/drug therapy , Consensus , East Asian People , Quality of LifeABSTRACT
Objective:To explore the clinical efficacy and adverse reactions of albumin-bound paclitaxel (Nab-P) and conventional paclitaxel combined with cisplatin and concurrent radiotherapy for the treatment of patients with locally advanced esophageal squamous cell carcinoma.Methods:Forty-nine patients with locally advanced esophageal squamous cell carcinoma admitted to the First People's Hospital of Suqian from November 2016 to May 2020 were included. Of the 49 patients, 23 cases were treated with Nab-P combined with cisplatin and concurrent radiotherapy (NP group), 26 cases were treated with conventional paclitaxel combined with cisplatin and concurrent radiotherapy (TP group). All patients received 2 cycles of chemotherapy. The curative efficacy was evaluated one month after the end of radiotherapy, and the curative effect and adverse reactions of the two treatment regimens were compared.Results:The objective remission rate in NP group was 78.3% (18/23), and the disease control rate was 100.0% (23/23). The objective response rate in TP group was 61.5% (16/26), and the disease control rate was 92.3% (24/26). The objective response rate and disease control rate in NP group were higher than those in TP group, but the differences were not statistically significant (both P > 0.05). The common adverse reactions were mainly hair loss, loss of appetite, bone marrow suppression, radiation esophagitis, radiation pneumonia, malaise and myalgia. The incidence rate of grade 3-4 acute bone marrow suppression in NP group (8.7%, 2/23) was lower than that in TP group (38.5%, 10/26), and the difference was statistically significant ( χ2 = 4.35, P = 0.037). The incidence rate of myalgia in NP group (26.1%, 6/23) was lower than that in TP group (61.5%, 16/26), and the difference was statistically significant ( χ2 = 4.85, P = 0.028). Conclusions:Nab-P combined with cisplatin and concurrent radiotherapy has good efficacy in the treatment of patients with locally advanced esophageal squamous cell carcinoma, and the incidence rate of adverse reactions is lower than that of conventional paclitaxel combined with cisplatin and concurrent radiotherapy, so that the regimen is safe.
ABSTRACT
OBJECTIVE To observe the clinical efficacy and safety of albumin-bound paclitaxel combined with nedaplatin inductive chemotherapy followed by concurrent radiochemotherapy in the treatment of loco-regionally advanced nasopharyngeal carcinoma. METHODS The clinical data of 45 patients （observation group ） with loco-regionally advanced nasopharyngeal carcinoma（Ⅲ/Ⅳa stage ）who received albumin-bound paclitaxel combined with nedaplatin inductive chemotherapy in our hospital from August 2017 to July 2018 were retrospectively analyzed. Propensity score was used to match 45 patients（control group ）with loco-regionally advanced nasopharyngeal carcinoma who received docetaxel combined with cisplatin and fluorouracil inductive chemotherapy. After inductive chemotherapy ，both groups received intensity-modulated radiochemotherapy （IMRT）；observation group was additionally given concurrent nedaplatin chemotherapy ，and control groups was given concurrent cisplatin chemotherapy. Clinical efficacy and the incidence of ADR were compared between 2 groups. RESULTS All patients completed treatment and 3-year follow-up. After inductive chemotherapy and 1，3 months after concurrent radiochemotherapy ，there was no statistical significance in short-term response between 2 groups（P＞0.05）. There was no significantly difference in 3-years local control rate and 3-years free from distant metastasis between 2 groups（P＞0.05）. The incidences of leucopenia （grade 3 or above ）in the observation group were significantly lower than those in the control group ，and the incidence of peripheral neuropathy in observation group was higher than that in control group （P＜0.05）. The incidences of thrombocytopenia （grade 2 or above ），rash and vomiting （grade 2 or above ）in the observation group were lower than those in the control group ，but the difference was not statistically significant （P＞0.05）. There was no significant difference in the incidence of other ADR between 2 groups（P＞0.05）. CONCLUSIONS Albumin-bound paclitaxel combined with nedaplatin inductive chemotherapy followed by concurrent chemoradiotherapy in the treatment of loco-regionally advanced nasopharyngeal carcinoma is effective and tolerable ．
ABSTRACT
OBJECTIVE To observe the ther apeutic efficacy and safety of albumin-bound paclitaxel combined with oxaliplatin in the first-line treatment of advanced gastric cancer （GC）. METHODS A total of 90 advanced unresectable GC patients were randomized into observation group and control group ，with 45 patients in each group. Control group was given oxaliplatin combined with tegafur ，and observation group was given albumin-bound paclitaxel combined with oxaliplatin. A chemotherapy cycle last for 21 days，and both groups received 6 cycles of chemotherapy ，and then the follow-up observation was conducted every 2 weeks. Short-term efficacy （after 2 chemotherapy cycles ），mid-term efficacy （after 6 chemotherapy cycles ），tumor marker，long-term efficacy （after follow-up ），quality of life ，the occurrence of ADRs were compared between 2 groups. RESULTS After 2 cycles of treatment ，objective remission rate （ORR）of observation group was significantly higher than that of control group （60.00％ vs. 37.78％，P＜0.05）；there was no statistical significance in disease control rate between the two groups （P＞0.05）. After 6 chemotherapy cycles ，ORR of observation group was significantly higher than that of control group （55.56％ vs. 31.11％，P＜0.05）；there was no statistical significance in disease control rate between the two groups （P＞0.05）；the levels of tumor markers [carcinoembryonic antigen ， carbohydrate antigen （CA）724， CA199， CA242] in observation group were significantly lower than those of control group （P＜0.05）. After the follow-up period ，the median progression-free survival [ 8.78 （95％CI：6.94-11.01）months] and the median overall survival [ 13.02（95％CI：12.78-15.62）months] of observation group were significantly longer than those [ 6.99（95％CI：3.67-10.88）months and 10.42（95％CI：8.72-13.22）months] of control group （P＜ 0.05）. The score of body dimension in the observation group was significantly higher than that in the control group （P＜0.05）. Except for peripheral neurotoxicity ，there was no significant difference in the incidence of ADR between 2 groups（P＞0.05）. CONCLUSIONS Albumin-bound paclitaxel combined with oxaliplatin has a good effect and safety in the first-line treatment of advanced unresectable GC.
ABSTRACT
Objective:To investigate the short-term efficacy and safety of albumin-bound paclitaxel combined with nedaplatin followed by concurrent radiotherapy in treatment of stage Ⅲ massive cervical cancer.Methods:The clinical data of 84 patients with massive cervical cancer admitted to Harbin Medical University Cancer Hospital from April 2019 to April 2020 were retrospectively analyzed. According to the different treatment regimens, patients were divided into the observation group and the control group, each with 42 cases. The observation group received albumin-bound paclitaxel combined with nedaplatin followed by concurrent radiotherapy, and the control group received solvent-based paclitaxel combined with nedaplatin followed by concurrent radiotherapy. The short-term efficacy and adverse reactions of the two groups were compared.Results:The partial remission (PR) rate of the observation group and the control group at 1 month of treatment was 92.9% (39/42) and 35.7% (15/42), respectively, and the difference was statistically significant ( χ2 = 29.867, P < 0.01). The complete remission (CR) rate of the observation group and the control group at 1 month after treatment was 59.5% (25/42) and 38.1% (16/42), respectively, and the difference was statistically significant ( χ2 = 3.859, P = 0.049). The incidence of diarrhea of the observation group was lower than that of the control group [33.33% (14/42) vs. 54.8% (23/42)], and the difference was statistically significant ( χ2 = 3.913, P = 0.048). There were no statistical differences in the incidence of hematological adverse reactions and abnormal liver and kidney functions between the two groups (all P > 0.05). Conclusion:The albumin-bound paclitaxel combined with nedaplatin followed by concurrent radiotherapy have a good short-term efficacy in treatment of stage Ⅲ massive cervical cancer, and the adverse reactions are tolerable.
ABSTRACT
Objective:To compare the short-term clinical efficacy, adverse reactions and pharmacoeconomics of advanced mutation negative lung adenocarcinoma treated by albumin-bound paclitaxel or pemetrexed combined with cisplatin.Methods:From September 2019 to October 2020, 80 patients with advanced lung adenocarcinoma diagnosed in the First Affiliated Hospital of Bengbu Medical College were divided into observation group and the control group according to the randomized digital table, with 40 cases in each group. The observation group received albumin-bound paclitaxel combined with cisplatin, and the control group received pemetrexed combined with cisplatin. After 2 cycles of treatment, the short-term efficacy and the adverse reactions of the two groups were evaluated. The cost of chemotherapy drugs and the average length of hospital stay were compared between the two groups.Results:The objective response rates of the observation group and the control group were 30.0% (12/40) and 32.5% (13/40), the disease control rates were 77.5% (31/40) and 82.5% (33/40) respectively, and there were no significant differences ( χ2=0.058, P=0.809; χ2=0.313, P=0.576). The adverse reactions of the two groups were mainly grade Ⅰ-Ⅱ. The incidences of leucopenia, neutropenia, thrombocytopenia, hemoglobin decreased, gastrointestinal reaction, liver function damage and renal function damage in the observation group were 20.0% (8/40), 20.0% (8/40), 20.0% (8/40), 17.5% (7/40), 37.5% (15/40), 12.5% (5/40) and 7.5% (3/40) respectively, those in the control group were 25.0% (10/40), 20.0% (8/40), 17.5% (7/40), 15.0% (6/40), 32.5% (13/40), 17.5% (7/40) and 5.0% (2/40) respectively, and there were no statistically significant differences between the two groups ( χ2=0.287, P=0.592; χ2<0.001, P>0.999; χ2=0.082, P=0.775; χ2=0.092, P=0.762; χ2=0.220, P=0.639; χ2=0.392, P=0.531; χ2<0.001, P>0.999). The median cost of chemotherapy drugs and the median length of hospital stay in the observation group were 7 453 yuan and 6 days respectively, which were less than 8 956 yuan and 7 days in the control group, with statistically significant differences ( Z=-3.057, P=0.002; Z=-2.733, P=0.006). Conclusion:The short-term efficacy of albumin-bound paclitaxel combined with cisplatin is equal to pemetrexed combined with cisplatin in treatment of advanced mutation negative lung adenocarcinoma, and the adverse reactions are similar. However, the average cost of chemotherapy drugs of albumin-bound paclitaxel combined with cisplatin is less than pemetrexed combined with cisplatin, and the average length of hospital stay is shorter.
ABSTRACT
OBJECTIVE：To evaluate th e effectiveness ，safety and economy of albu min-bound paclitaxel （nab-PTX）in the treatment of breast cancer by using rapid health technology assessment （HTA），and to provide evidence-based reference for drug selection. METHODS ：Retrieved from PubMed ，the Cochrane Library ，CNKI，Wangfang database and other databases ，systematic evaluation/Meta-analysis，HTA and pharmacoeconomic studies about nab-PTX in the treatment of breast cancer were included ；the conclusions were classified and analyzed by using descriptive analysis. RESULTS ：A total of 5 systematic reviews/Meta-analysis ， 8 pharmacoeconomic studies were included in this study. Compared with conventional taxanes ，nab-PTX increased pathological complete response （pCR）rate [OR ＝1.39，95％CI（1.16，1.67），P＜0.001] and event-free survival （EFS）[HR＝0.69，95％CI（0.57， 0.85），P＜0.001] in neoadjuvant chemotherapy （NAC）-treated breast cancer patients. However ，there were no significant differences in overall survival （OS），progression-free survival （PFS），objective response rate （ORR）and disease control rate （DCR）in metastatic breast cancer （MBC）patients between 2 groups. In the terms of safety ，nab-PTX increased the incidence of grade 3-4 sensory neuropathy [OR ＝1.89，95％CI（1.36，2.61），P＜0.001] in MBC patients ，and increased the incidence of neutropenia [OR ＝ 1.52，95％CI（1.23，1.88，P＜0.001]，sensory neuropathy [OR ＝ 2.17，95％CI（1.38，3.40），P＜0.001]，rash [OR ＝1.46，95％CI mei1213@163.com （1.18，1.80），P＜0.001] and fatigue [OR ＝1.28，95％CI（1.04， 1.56）， P＝0.02] in NAC -treated breast cancer patients.Pharmacoeconomic studies showed that nab-PTX could improve the quality adjusted lif e years of MBC patients compared with traditional taxanes ，and it was a economical option. CONCLUSIONS：Nab-PTX enhances pCR in NAC-treated breast cancer patients ，but has no significant advantage in the effectiveness of MBC patients ，and increases the occurrence of ADR. Nab-PTX may have a cost-utility advantage over conventional taxanes for MBC.
ABSTRACT
Context: Nanoparticle albumin-bound paclitaxel (Nab-PTX) is a form of paclitaxel bound to albumin nanoparticles and is used widely in a neoadjuvant setting for patients with breast cancer. Aims: We conducted a retrospective study to compare the efficacy and safety of Nab-PTX to PTX as neoadjuvant chemotherapy for patients with operable HER2-negative breast cancer. Settings and Design: In total, 50 patients were enrolled. Nab-PTX was administered in the study group, and PTX was administered in the control group. Subjects and Methods: The clinical response and safety profile were recorded. The expression of secreted protein acidic rich in cysteine (SPARC) in tumor tissue was examined. Statistical Analysis: The efficacy and safety analyses were computed using SPSS statistical software. Multiple logistic regression analysis was performed to evaluate the exploratory variables (age, stage, estrogen receptor, partial response, and SPARC expression) for the pathological complete response (pCR), and Fisher's exact test was performed to evaluate the relationship between SPARC and pCR. Results: Both groups of patients achieved a good clinical response. The pCR rate for the Nab-PTX regimen was significantly higher than that for the PTX regimen. The most common adverse events were neutropenia, peripheral sensory neuropathy, arthralgia, and myalgia. In 68% of cases in the Nab-PTX group, high SPARC expression was observed. Conclusions: As neoadjuvant therapy, the Nab-PTX regimen has advantages over conventional taxane regimen in patients with HER2-negative breast cancer. With this regimen, a high pCR rate was achieved with a good safety profile
ABSTRACT
Objective@#To investigate the efficacy and safety of albumin-bound paclitaxel in the treatment of advanced malignant tumors.@*Methods@#Patients in advanced stage of cancer who had had drug-resistant relapse after receiving multiple-line treatment received chemotherapy with albumin-bound paclitaxel from May 2016 to April 2018 in Daxing Hospital of Capital Medical University. Their clinical data were collected to evaluate the treatment efficacy and safety profile.@*Results@#36 patients who had advanced treatment-resistent tumors with evaluable data were enrolled. Of 36 patients, 55.56% (20) had previously received chemotherapy with paclitaxel. The objective response rate (ORR) was 8.33%, the disease control rate (DCR) was 25.0%, the median progression free survival (PFS) was 106 days, and the median overall survival (OS) was 183 days. The main adverse reactions of grade 3-4 were hematological toxicity, including neutropenia [36.11% (13/36)], anemia and thrombocytopenia [5.56% (2/36) and 16.67% (6/36)] in patients without neutropenia fever. Adverse effects of 3-4 degrees related to non-hematologic toxicity were not observed.@*Conclusions@#Chemotherapy regimen with albumin-bound paclitaxel has certain efficacy for advanced malignant tumors resistant to multiple lines of therapy and the adverse effects could be generally tolerated.
ABSTRACT
Immunosuppressive cells in the pancreatic cancer microenvironment play an important role in tumor development. Various immunosuppressive cytokines are secreted by these cells. Immunosuppressive cells may also influence the chemotherapeutic effect as well as promote drug resistance. Gemcitabine, albumin-bound paclitaxel, and other first-line chemotherapy agents not only suppress the proliferation of pancreatic cancer cells directly but also indirectly reinforce the anti-tumor effect of immune cells. However, chemo-therapeutic drugs may also induce immunosuppression, drug resistance, and tumor progression. In this review, we summarize the im-munosuppressive features of the pancreatic cancer microenvironment and its reciprocal relationship with chemotherapy, aiming to op-timize the current chemotherapy strategies from the perspective of the tumor immune microenvironment.
ABSTRACT
Objective To investigate the efficacy and safety of albumin-bound paclitaxel in the treatment of advanced malignant tumors.Methods Patients in advanced stage of cancer who had had drug-resistant relapse after receiving multiple-line treatment received chemotherapy with albumin-bound paclitaxel from May 2016 to April 2018 in Daxing Hospital of Capital Medical University.Their clinical data were collected to evaluate the treatment efficacy and safety profile.Results 36 patients who had advanced treatment-resistent tumors with evaluable data were enrolled.Of 36 patients,55.56％ (20) had previously received chemotherapy with paclitaxel.The objective response rate (ORR) was 8.33％,the disease control rate (DCR) was 25.0％,the median progression free survival (PFS) was 106 days,and the median overall survival (OS) was 183 days.The main adverse reactions of grade 3-4 were hematological toxicity,including neutropenia [36.11％ (13/36)],anemia and thrombocytopenia [5.56％ (2/36)and 16.67％ (6/36)]in patients without neutropenia fever.Adverse effects of 3-4 degrees related to non-hematologic toxicity were not observed.Conclusions Chemotherapy regimen with albumin-bound paclitaxel has certain efficacy for advanced malignant tumors resistant to multiple lines of therapy and the adverse effects could be generally tolerated.
ABSTRACT
A 58-year-old woman presented with right flank and back pain for one month. After undergoing an abdominal computed tomography (CT), she was referred to our hospital. The abdominal CT showed a hypodense pancreatic tail mass with multiple retroperitoneal lymph node metastases. Positron emission tomography-computed tomography (PET-CT) scan showed high 18F-FDG uptake in pancreatic tumor and enlarged lymph nodes. Endoscopic ultrasound fine needle aspiration (EUS-FNA) revealed adenocarcinoma, which stained strongly in hENT1 (human equilibrative nucleoside transporter 1) on immunohistochemistry. She received gemcitabine 1,000 mg/m² + nanoparticle albumin-bound paclitaxel 125 mg/m² as a palliative chemotherapy. Follow-up abdominal CT and PET-CT after 4 cycles of chemotherapy showed that both pancreatic mass and the metastatic retroperitoneal lymph nodes were nearly disappeared. We report a case of 58-year-old female with metastatic pancreatic cancer who had a dramatic response to palliative chemotherapy (gemcitabine plus nanoparticle albumin-bound paclitaxel).
Subject(s)
Female , Humans , Middle Aged , Adenocarcinoma , Albumin-Bound Paclitaxel , Back Pain , Biopsy, Fine-Needle , Drug Therapy , Electrons , Fluorodeoxyglucose F18 , Follow-Up Studies , Immunohistochemistry , Lymph Nodes , Nanoparticles , Neoplasm Metastasis , Nucleoside Transport Proteins , Pancreatic Neoplasms , Tail , Tomography, X-Ray Computed , UltrasonographyABSTRACT
Objective To evaluate the clinical efficacy and safety of nanoparticle albumin-bound paclitaxel (Nab-P) in the treatment of advanced non-small cell lung cancer (NSCLC). Methods Fifty-six over 65 years old patients with advanced NSCLC treated with Nab-P monotherapy in department of chemotherapy of the People's Hospital of Zhongshan City from January 2014 to January 2017 were analyzed retrospectively. The chemotherapy regimen was Nab-P 260 mg/m2, on d1 or d1 + d8, every 21 day for a cycle, imaging examination was made for efficacy evaluation after every 2 cycles. Results All 56 patients had been evaluated for efficacy, and received a total of 186 cycles of chemotherapy. All patients had been completed 2 cycles or more than 2 cycles of chemotherapy, and the median number of chemotherapy cycles was 3. The treatment response rate (RR) was 25.0 ％ and the disease control rate (DCR) was 76.8 ％. The median progression free survival (PFS) time was 4.7 months. The main adverse reactions were neutropenia, nausea and vomiting, fatigue and peripheral nerve toxicity. However, the vast majorities of adverse reactions were grade 1-2, and can be improved after treatment. Conclusions Nab-P is effective in the treatment of advanced NSCLC in elderly patients. The adverse reactions are mild and tolerant, and it is worthy to be popularized.
ABSTRACT
OBJECTIVE: To report on the incidence of nab-paclitaxel hypersensitivity reactions (HSRs) in patients with prior taxane HSR. METHODS: From 2005 to 2015, all patients who received nab-paclitaxel for a gynecologic malignancy were identified. Chart abstraction included pathology, prior therapy, indication for nab-paclitaxel, dosing, response, toxicities including any HSR, and reason for discontinuation of nab-paclitaxel therapy. RESULTS: We identified 37 patients with gynecologic malignancies with a history of paclitaxel HSR who received nab-paclitaxel. Six patients (16.2%) had a prior HSR to both paclitaxel and docetaxel while the other 31 patients had not received docetaxel. No patients experienced a HSR to nab-paclitaxel. Median number of cycles of nab-paclitaxel was 6 (range 2–20). Twelve patients received weekly dosing at 60 to 100 mg/m². The remainder of patients received 135 mg/m² (n=13), 175 mg/m² (n=9), or 225 mg/m² (n=3). Thirty four patients (91.9%) received nab-paclitaxel in combination with carboplatin (n=28, 75.7%), IP cisplatin (n=1, 2.7%), carboplatin and bevacizumab (n=3, 8.1%), or carboplatin and gemcitabine (n=2, 5.4%). Reasons for discontinuing nab-paclitaxel included completion of adjuvant therapy (n=16), progressive disease (n=18), toxicity (n=1), and death (n=1). There were no grade 4 complications identified during nab-paclitaxel administration. Grade 3 complications included: neutropenia (n=9), thrombocytopenia (n=4), anemia (n=1), and neurotoxicity (n=1). CONCLUSION: Nab-paclitaxel is well-tolerated with no HSRs observed in this series of patients with prior taxane HSR. Given the important role of taxane therapy in nearly all gynecologic malignancies, administration of nab-paclitaxel should be considered prior to abandoning taxane therapy.
Subject(s)
Humans , Albumin-Bound Paclitaxel , Anemia , Bevacizumab , Carboplatin , Cisplatin , Drug Hypersensitivity , Drug Therapy , Hypersensitivity , Incidence , Neutropenia , Paclitaxel , Pathology , ThrombocytopeniaABSTRACT
Objective To observe the efficacy and safety of albumin bound paclitaxel in the treatment of retreatment advanced non-small-cell lung cancer (NSCLC).Methods Retreatment NSCLC patients failed from first line regimen or beyond were treated with albumin bound paclitaxel weekly by intravenous dose of 130 mg/m2 on day 1 and day 8,with a 21-day cycle.Efficacy was evaluated every two cycles and side effects were observed during each cycle.Results None of 69 patients achieved complete remission (CR),15 patients (21.7 ％) achieved partial remission (PR),and 23 patients (33.4 ％) achieved stable disease (SD).Objective response rate (ORR) was 21.7 ％,disease control rate (DCR) was 55.1％,and progress free survival (PFS) time was 3.8 months.Efficacy was not correlated with gender,age,histology and lines of previous treatment (all P ＞ 0.05).Main adverse reactions included neutropenia,alopccia and neurotoxicity,which were all tolerable.Conclusion Weekly albumin bound paclitaxel is effective and well tolerated in the treatment of retreatment advanced NSCLC,which can be considered as the second line or beyond regimen.
ABSTRACT
Objective:To provide reference for clinical pharmacist in the treatment of severe bone marrow suppression complicated with infection induced by chemotherapeutic drugs .Methods:The pharmaceutical care was performed by clinical pharmacist for a pa-tient with severe bone marrow suppression complicated with pulmonary infection caused by chemotherapy .The suggestions on the drug use in the evaluation of chemotherapy regimen and the treatment of bone marrow suppression and infection were provided .Results:The bone marrow inhibition was relieved , the pulmonary infection was improved , and no other severe adverse reactions were shown .Con-clusion:Clinical pharmacist can improve effectiveness and safety in the treatment of patients with severe bone marrow suppression by providing individualized drug treatment .
ABSTRACT
Background and purpose: Pancreatic cancer is often diagnosed at advanced stage, therefore, chemotherapy remains the cornstone of treatment for advanced pancreatic cancer. However, no standard regimen has been established as second-line therapy for advanced pancreatic cancer. The purpose of the study was to evaluate the efifcacy and safety of albumin-bound paclitaxel plus S-1 for the treatment of advanced pancreatic cancer patients in second-line setting after the failure of gemcitabine treatment. Methods:Clinical outcomes of 19 patients with advanced pancreatic cancer were analyzed. These patients received albumin-bound paclitaxel plus S-1 as second-line therapy after the failure of gemcitabine treatment. Albumin-bound paclitaxel was administered at a dose of 125 mg/m2 over 30 minutes on day 1 and 8 of a 21-day cycle. From d1-14, all patients received oral S-1 40 mg/m2, twice daily. Results:All patients were available for evaluation. Of the 19 patients, 1 case got complete response (CR), 4 cases had partial response (PR) and 9 cases had stable disease (SD). The objective response rate (ORR) was 26.3%, the disease control rate (DCR) was 73.7%and the median progression free survival (PFS) was 5.2 months. The main toxicities include hematological toxicity, myodynia, gastrointestinal reactions, sensory neuropathy, fatigue and alopecia. Conclusion:The combination of albumin-bound paclitaxel and S-1 is effective and tolerated in the treatment of advanced pancreatic cancer patients who resistant to gemcitabine.
ABSTRACT
Background and purpose:Nab-paclitaxel (Abraxane) is an albumin-bound form of paclitaxel that utilizes the natural properties of albumin to improve paclitaxel delivery to the tumor. It has recently been approved for treatment of breast cancer after failure of combination chemotherapy for metastatic disease or relapse within short time after adjuvant chemotherapy. The purpose of this study was to evaluate the efifcacy and safety of albumin-bound paclitaxel in patients with aggressive and refractory metastatic breast cancer (MBC).Methods:A total of 58 patients with MBC were enrolled into this study from Jul. 2009 to Jan. 2014. All patients received albumin-bound paclitaxel-based chemotherapy. The adverse reactions were evaluated every cycle, and the short-term response was evaluated every two cycles. The patients were followed-up, and the survival was analyzed.Results:58 patients with refractory MBC were evaluable for response, 67.2% of patients received multiple line (≥3 lines) chemotherapy, 32.8% of patients with first and second line of chemotherapy were involved metastasis within one year after adjuvant chemotherapy, 84.5% of patients with visceral metastasis and 93.1% with prior taxane treatment. The objective response rate (ORR) was 13.8%, and disease control rate (DCR) was 60.3%, the median progression free survival (PFS) was 4.0 months, and the overall survival (OS) was 10.1 months. For 23 patients with triple negative breast cancer, ORR was 13.0% and DCR was 56.5%, the median PFS was 4.1 months, and OS was 6.6 months. The main toxicity was myelosuppression (grades 3 and 4 neutropenia, anemia and thombocytopenia were seen in 34.5%, 12.1% and 6.9% of patients, respectively), gastrointestinal reactions, sensory neuropathy, myodynia/arthragia, fatigue, alopecia and so on.Conclusion:The albumin-bound paclitaxel-based chemotherapy can be used in aggressive and refractory MBC. It also showed antitumor activity in taxanes-resistance patients and triple negative patients with good safety and tolerance.
ABSTRACT
Objective To investigate the efficacy,adverse reaction and survival condition of albumin-bound paclitaxel combined with bevacizumab as second-line therapy in patients with advanced pancreatic cancer. Methods Twenty-seven cases of advanced pancreatic cancer were enrolled to receive albumin-bound paclitaxel combined with bevacizumab regimen. The dose of the drugs was as follows:albumin-bound paclitaxel 130 mg/ m2 ,d1,bevacizumab 7. 5 mg/ m2 ,d1. Twenty-one days were a cycle for each regimen,and the least chemotherapy cycle was 2. The adverse reactions were evaluated for each cycle and the objective response was evaluated for 2 cycles. Results The 27 patients could be evaluated. None was in complete remission,2 cases were in partial remission,14 cases were in stabilization,11 cases were in progress. The response rate(RR) was 7. 41% ,and the disease control rate(DCR)was 59. 26% . The median progress free survival(PFS)was 4 months(95% CI:3. 004-4. 996 months),and the median overall survival(OS)was 8 months(95% CI:5. 900-10. 100 months). The main adverse reactions included myelosuppression,gastrointestinal reaction, fatigue,lipsotrichia,erythra,peripheral neurotoxicity,etc,most of which were 1-2 grade. The adverse effect was well tolerated,and there was no treatment-related death. Conclusion The albumin-bound paclitaxel com-bined with bevacizumab as second-line therapy in patients with advanced pancreatic cancer shows slow progress and low adverse effect and needs further study.