Efficacy and Safety of Weekly Paclitaxel in Breast Cancer With Symptomatic Bone Marrow Infiltration

Anticancer Res. 2020 May;40(5):2955-2960. doi: 10.21873/anticanres.14274.

Abstract

Background/aim: Currently, there is no recommendation for the treatment of breast cancer (BC) with bone-marrow cell infiltration (BMI). We evaluated the efficacy and safety of weekly-paclitaxel in this population.

Patients and methods: This retrospective study included all BC patients with BMI receiving weekly-paclitaxel between January 2014 and May 2018. Overall-survival (OS) was the primary endpoint. Secondary endpoints were progression-free-survival (PFS) and safety.

Results: BMI was diagnosed in 26 patients. This infiltration was suggested by peripheral blood smear in 73% of cases. All patients had anemia, and 77% had thrombocytopenia. OS and PFS were 7.2 months [95% confidence interval (CI)=2.6-20.7] and 3.3 months (95%CI=1.6-7.2), respectively. Good performance-status, absence of thrombocytopenia and presence of less than 5% of circulating erythroblasts at BMI diagnosis, were associated with better survival. One patient presented grade 5 febrile neutropenia but no episodes of bleeding were reported.

Conclusion: Weekly-paclitaxel is an effective therapeutic option with limited toxicity for BC with BMI.

Keywords: Breast cancer; bone marrow infiltration; erythroblastic blood smear; weekly paclitaxel.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents, Phytogenic / pharmacology
  • Antineoplastic Agents, Phytogenic / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology
  • Drug Administration Schedule
  • Female
  • Humans
  • Middle Aged
  • Paclitaxel / pharmacology
  • Paclitaxel / therapeutic use*
  • Survival Analysis

Substances

  • Antineoplastic Agents, Phytogenic
  • Paclitaxel