by Manon Réda,
Anaïs Fouquier, Isabelle Desmoulins, Didier Mayeur, Courèche Kaderbhai, Silvia
Ilie, Audrey Hennequin, Bruno Coudert, Aurélie Bertaut, Sylvain Ladoire
The Breast: Published:February 04, 2023
Background
Taxanes are major
drugs for metastatic breast cancer (MBC) treatment, and are generally well
tolerated, making them attractive for therapeutic reintroduction (rechallenge)
during metastatic course. In view of the paucity of current literature, we
questioned the usefulness of taxane rechallenge in a population of patients
previously treated with taxanes in a metastatic setting.
Methods
From the local
database of a French cancer center, we retrospectively identified 756 patients
diagnosed with ER+/HER2-, or triple negative MBC, and treated between 2008 and
2021. Among them, 58 patients (7.8%) were rechallenged with taxanes. Clinical
characteristics, response rates, and survival were retrospectively evaluated
and compared to patients who received taxanes only once.
Results
Compared to
non-rechallenged population, patients treated with taxane rechallenge were
significantly younger, with better general status, and received more treatment.
First taxane exposure led to better tumor response and was more frequently
discontinued for reasons other than progression, compared to the
non-rechallenged population. Taxane rechallenge led to an objective response
rate of 27.6%, and a clinical benefit rate of 46.6%, with a median
progression-free survival (PFS) of 5.7 months, and a median overall survival
(OS) of 11.6 months. We also found a PFS2/PFS1 ratio >1.3 in 55.2% of the
rechallenge population.
Conclusion
Although only a
minority of MBC patients are concerned, taxane rechallenge appears to be a
pragmatic option with an acceptable tolerance, and good efficacy, especially
when these drugs have shown clinical activity earlier in the disease course,
and/or have been stopped for reasons other than progression.
