Combination of Ixabepilone and Capecitabine in Metastatic Triple Negative Breast Cancer. Clinical case

Abstract

Metastatic triple negative breast cancer is considered to be a chemosensitive malignancy especially in treatment-naïve setting. However, tumor cells are able to develop various mechanisms of drug resistance and eventually they become insusceptible for common cytostatic agents. Expansion of treatment-resistant tumor cells represents significant therapeutic challenge and this leads to unfavorable prognosis of advanced triple negative breast cancer. Backbone of treatment for patients with this disease is sequential treatment with various cytostatic drugs with non-cross resistant mechanisms of action, however even with the stateof-art therapy median overall survival does not exceed 15 months. The integration of novel epothilone analogue ixabepilone into clinical practice appears to be a promising strategy for the treatment of advanced pretreated triple-negative breast cancer, especially for patients who are resistant to taxanes and anthracyclines. Combination of ixabepilone with capecitabine is superior to capecitabine monotherapy in terms of response rate (34.7% vs 14.3% with capecitabine monotherapy) and median progressionfree  survival (5.8 months vs 4.2 months). At the same time ixabepilone has favorable safety profile and manageable toxicity, 67% developed peripheral neuropathy which is comparable to neuropathy rate with other microtubule inhibitors such as taxanes and eribuline. Here we describe a clinical case of patient with heavily pretreated metastatic triple negative breast cancer resistant to taxanes, anthracyclines and eribuline who was successfully treated with ixabepilone and capecitabine combination.