Quality of Life During Maintenance Therapy Better With Lower Dose, More Often
In this study, the affect on quality of life from 3 different maintenance nab-paclitaxel dose regimens was examined.
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Reduced maintenance chemotherapy using nab-paclitaxel, after a short-term induction phase at conventional doses was shown to improve progression-free survival in patients with metastatic breast cancer, according to results from the phase II SNAP trial presented at the 2017 San Antonio Breast Cancer Symposium (SABCS 2017).
The SNAP II trial evaluated 3 different maintenance nab-paclitaxel dose regimens. For this study, researchers evaluated the effect of those regimens on patients' quality of life (QOL).
Of 258 patients enrolled in the trial, 255 were included in the quality-of-life analysis. The patients were randomized to 3 arms. All participants received induction chemotherapy based on 3 cycles of nab-paclitaxel 150 mg/m2 on days 1, 8, and 15 of 28 days. (The dose was reduced to 125 mg/m2 after a safety review.) The randomized groups received maintenance therapy in 28-day cycles: 150 mg/m2 on days 1 and 15 (group A); 100 mg/m2 on days 1, 8, and 15 (group B); 75 mg/m2 on days 1, 8, 15, and 22 (group C).
All participants completed a questionnaire that assessed global and symptom-specific indicators at baseline and at day 1 of every cycle for the first 12 cycles on treatment, or until treatment was discontinued. All participants underwent initial induction therapy, during which the most pronounced worsening of QOL was observed, with mean changes in hair loss, sensory neuropathy, and treatment burden. During maintenance therapy, sensory neuropathy remained impaired, but did not worsen.
Patients who received low but frequent doses of nab-paclitaxel (groups B and C) had a significant difference in hair loss compared with group A, which received a higher, less frequent dose. Patients in the lowest dose group (group C) also reported a significantly greater improvement in mood than the highest dose group (group A). Considering the findings, the researchers noted, “a more frequent administration of reduced-dose chemotherapy agents is favorable with respect to quality of life.”
Ribi K, Sun Z, Jerusalem G, et al. Nab-paclitaxel-based therapy in the first line treatment of metastatic breast cancer (IBCSG 42-12/BIG 2-12 SNAP): impact of different schedules on quality of life. Poster presentation at: 2017 San Antonio Breast Cancer Symposium; December 6-9, 2017; San Antonio, TX. Abstract P5-18-02.