Supporting Asian patients with metastatic breast cancer during ixabepilone therapy.
BACKGROUND
Ixabepilone is currently FDA-approved in metastatic breast cancer, and most patients in the registrational trials were Caucasian. Studies in Asian populations receiving other cytotoxic agents have revealed differential pharmacokinetics and clinical outcomes. As such, clinicians should understand the possible contributions of Asian ethnicity and culture to the clinical profile of ixabepilone.


METHODS
Studies in Asian patients receiving other chemotherapeutics reported altered toxicity profiles for myelosuppression, neurotoxicity and gastrointestinal symptoms. Encouragingly, the limited clinical data in Asian patients receiving ixabepilone suggest that efficacy and toxicity in these women resemble those reported in the ixabepilone registrational trials.


RESULTS
The reader will better understand how Asian genetics and culture may influence treatment outcomes and patient attitudes toward therapy and interaction with caregivers. Management of ixabepilone-related adverse events is also discussed with an emphasis on special considerations for Asian patients.


CONCLUSIONS
Awareness of possible altered drug response in Asian patients will aid clinicians in monitoring for toxicity, recognizing the need for dose modification and educating patients. Sensitivity to cultural aspects that are unique to Asians may improve adherence, reporting of adverse events and trust among Asian patients receiving ixabepilone.
Bourdeanu
Laura
L
Department of Medical Oncology & Therapeutics Research, Duarte, CA 91010-3000, USA. lbourdeanu@coh.org
Wong
Siu-Fun
SF
D044466:Asian People / Q000208:ethnology*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000208:ethnology* / Q000378:metabolism; D019468:Disease Management; D034261:Epothilones / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D009437:Neuralgia / Q000139:chemically induced / Q000208:ethnology; D016896:Treatment Outcome
D034261:Epothilones; C430592:ixabepilone