title: Neoadjuvant chemotherapy for breast cancer with weekly nab-paclitaxel followed by epirubicin and cyclophosphamide--results of a case series.
abstract: OBJECTIVE
  To substitute paclitaxel in neoadjuvant chemotherapy of breast cancer by nab-paclitaxel due to its improved efficacy and safety profile.
  
  
  METHODS
  Sixteen patients with primary breast cancer received neoadjuvant chemotherapy with 4 cycles of nab-paclitaxel at 150 mg/m(2) (d1, 8, 15, every 28 days followed by 4 cycles of epirubicin at 90 mg/m(2) d1, every 21 days and cyclophophosphamide at 600 mg/m(2) (d1, every 21 days plus, if human epidermal growth factor receptor 2 (HER2)-positive, trastuzumab, and in 2 cases trastuzumab and lapatinib. End-points were the rate of pathological complete response (pCR) and safety.
  
  
  RESULTS
  All patients responded after two cycles. Overall, 11/16 patients had pathological complete response: 5/6 with HER2-positive, 3/4 with triple-negative and 3/6 with HER2-negative, hormone receptor-positive disease. Adverse events of grade 3 or more occurred in 4 patients. There were no grade 4 or 5 toxicities. The most frequent side-effects (all grades) were peripheral polyneuropathy (n=11, n=4 grade 2), fatigue (n=9) and hand-foot syndrome (n=8). Overall, side-effects were easily managed.
  
  
  CONCLUSIONS
  Neoadjuvant chemotherapy with nab-paclitaxel is a good alternative to paclitaxel-based regimens.
authors.affiliation: Department of Gynecology, Stadtklinik Baden-Baden, Balger Str. 50, 76532 Baden-Baden, Germany. a.hahn@klinikum-mittelbaden.de.
authors.forename: Antje
authors.initials: A
authors.lastname: Hahn
authors.forename: Claus M
authors.initials: CM
authors.lastname: Schlotter
authors.forename: Winfried G
authors.initials: WG
authors.lastname: Rossmanith
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Ulmer
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Staiger
authors.forename: Carlos
authors.initials: C
authors.lastname: Villena
mesh_terms: D000328:Adult; D000368:Aged; D000418:Albumins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D003520:Cyclophosphamide / Q000008:administration & dosage; D004334:Drug Administration Schedule; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: C520255:130-nm albumin-bound paclitaxel; D000418:Albumins; D015251:Epirubicin; D003520:Cyclophosphamide; D017239:Paclitaxel
keywords: Breast cancer; nab-paclitaxel; neoadjuvant chemotherapy