Abraxane the best taxane for metastatic breast cancer?

When administered weekly at doses of 100 or 150 mg/m², the nanoparticle albumin-bound formulation of paclitaxel [Abraxane] may be more active, and associated with less toxicity, than the US FDA approved dose of docetaxel [Taxotere] given every 3 weeks in the first-line treatment of metastatic breast cancer, according to data presented at the 29th Annual San Antonio Breast Cancer Symposium (SABCS) [San Antonio, Texas, US; December 2006]. Interim results of the head-to-head phase II trial demonstrated that first-line treatment with weekly paclitaxel significantly increased objective response rates by more than 60%, compared with docetaxel therapy. Both weekly dosing regimens of paclitaxel were also associated with a significant increase in objective response rate, compared with a third paclitaxel treatment arm which received a 300 mg/m² dose of paclitaxel every 3 weeks. Compared with docetaxel, all three paclitaxel arms demonstrated a more favourable tolerability profile, with significantly lower incidences of grade IV neutropenia, febrile neutropenia, and grade I or II stomatitis/mucositis; there were no significant between-treatment differences for peripheral neuropathy. In this study, paclitaxel 100 mg/m², administered weekly, demonstrated the most favourable balance between efficacy and tolerability, and is the selected dosing regimen for a proposed worldwide phase III registration trial of Abraxane.