Neoadjuvant ixabepilone promising against breast cancer

NEW YORK (Reuters Health) - Neoadjuvant monotherapy with ixabepilone can be effective in certain patients with invasive breast cancer.

Among predictors of a complete clinical response are estrogen-receptor (ER) gene expression and the microtubule-associated protein tau.

In the December online issue of the Journal of Clinical Oncology, Dr. Jose Baselga of Vall d'Hebron University Hospital, Barcelona, Spain, and colleagues report on their study of 161 patients who received up to 4 cycles of ixabepilone administered as a 3-hour infusion on day 1 of a 21-day cycle for no more than 4 cycles. Eventually, 154 patients underwent surgery (breast conserving surgery in 32% and mastectomy in the remainder).

The overall complete pathological response rate was 18%. In ER-negative patients, it was 29%.

Genetic data from 134 patients showed that ER gene expression was inversely related to complete pathologic response and had a positive predictive value of 37% and a negative predictive value of 92%.

A 10-gene model developed from 200 genes predictive of sensitivity in experiments, which included ER and tau, had a positive predictive value of 45% and a negative predictive value of 89%.

Thus, say the investigators "this study successfully identified patients who were most likely to benefit from neoadjuvant ixabepilone treatment."

"Neoadjuvant ixabepilone demonstrated promising activity and a manageable safety profile in patients with invasive breast tumors," the authors conclude.

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