Dr. Carey Discusses Findings From the CALGB40502 Trial in TNBC

Lisa A. Carey, MD, professor, UNC Lineberger Comprehensive Cancer Center, discusses findings from the CALGB 40502/NCCTG N063H trial in triple-negative breast cancer (TNBC).

This phase III randomized trial of patients with HER2-negative breast cancer enrolled 799 patients to receive paclitaxel, nab-paclitaxel (Abraxane), or ixabepilone—and most patients also received concurrent bevacizumab (Avastin; 98%). Improvements in overall survival (OS) and progression-free survival were seen with nab-paclitaxel compared with standard paclitaxel for patients with metastatic TNBC. The median OS with nab-paclitaxel was 21.0 months compared with 15.3 months with standard paclitaxel, representing a 26% reduction in risk of death with the hazard ratio of 0.74 (95% CI, 0.51-1.07).

In a subset analysis, an interaction was observed in the clinical subtype where the difference between nab-paclitaxel and paclitaxel varied. In TNBC, nab-paclitaxel outperformed paclitaxel, and the opposite was true for patients with hormone receptor-positive/HER2-negative breast cancer. This data is intriguing and hypothesis generating, Carey says, and it is something to be aware of when looking at other studies of this type.