Abstract:

Objective To observe the efficacy and safety of albumin paclitaxel in patients with advanced breast cancer. Methods A retrospective analysis was performed on 138 patients with advanced breast cancer admitted to Xiangyang Central Hospital from June 2018 to June 2021. The patients were divided into groups according to molecular type， number of treatment lines for albumin paclitaxel， number of metastatic sites， specific metastatic sites， past use of docetaxel and paclitaxel and combination therapy of albumin paclitaxel. Median progression-free survival （mPFS） and treatment-related adverse reactions in different subgroups treated with albumin paclitaxel were investigated. Survival curves were plotted by Kaplan-Meier method and log-rank test was performed， and multivariate analysis was performed by Cox model. Results The mPFS of the overall population was 8.2 months. The mPFS of triple negative breast cancer， human epidermal growth factor receptor-2 （HER-2） positive breast cancer and Luminal breast cancer were 6.4 months， 11.2 months and 8.1 months respectively， with a statistically significant difference （χ²=7.42， P=0.025）. The mPFS of patients treated with first- and second-line albumin paclitaxel was 9.5 months， and the mPFS of patients treated with third- to seventh-line was 6.3 months （χ²=3.86， P=0.049）. The mPFS of patients with ≤3 metastatic sites was 8.1 months， and the mPFS of patients with >3 metastatic sites was 7.0 months （χ²=0.38， P=0.535）. The mPFS of patients with liver and brain metastases was 6.8 months， and the mPFS of patients with extrahepatic and extracerebral metastases was 9.6 months （χ²=7.53， P=0.006）. The mPFS of patients who had previously treated with docetaxel and paclitaxel was 8.2 months， and the mPFS of patients who had not previously received docetaxel or paclitaxel was 9.6 months （χ²=0.03， P=0.862）. The mPFS of patients with albumin paclitaxel combined with targeted therapy， combined with immunotherapy， combined with chemotherapy and monotherapy were 12.1， 7.8， 9.0 and 7.1 months respectively， with a statistically significant difference （χ²=8.96， P=0.030）. Multivariate analysis showed that molecular type （triple negative breast cancer RR=1.87， 95%CI： 1.24-4.22， P=0.008； HER-2 positive breast cancer RR=0.63， 95%CI： 0.52-0.94， P=0.042）， number of treatment lines （RR=0.67， 95%CI： 0.32-0.86， P=0.011）， specific metastatic sites （RR=1.26， 95%CI： 1.12-2.75， P=0.014） and combination therapy （combined with targeted therapy RR=0.74， 95%CI： 0.16-0.86， P=0.021； combined with chemotherapy RR=0.93， 95%CI： 0.48-0.96， P=0.045； combined with immunotherapy RR=0.81， 95%CI： 0.17-0.78， P=0.032） were independent factors for prognosis. The main adverse reactions were alopecia， neutropenia， peripheral neurotoxicity and rash， and there was no death caused by adverse reactions. Conclusion Albumin paclitaxel is effective in the treatment of advanced breast cancer with controllable adverse reactions.

Key words: Breast neoplasms, Paclitaxel, Prognosis