الفهرس 
Evaluation Of Re-Challenging Approach With Taxanes In Advanced Breast Cancer Relevant To Biological Subtypes
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Abstract
This study was conducted to determine the efficacy of taxane-based regimens in patients with metastatic breast cancer pre-treated with taxanes in adjuvant/Neo-adjuvant treatment in correlation with breast cancer subtypes and impact of TILs on breast cancer prognosis in metastatic setting.
Methods: The study include 173 patients diagnosed with metastatic/locally recurrent breast cancer between November 2018 and November 2020, patients recived taxane based protocol as re-challenge or non-taxane systemic treatment as per institute protocol,the 2 regimen`s were repeated every 3 weeks Assessment of TILs in the available specimen for initial lesion before anytype of chemotherapy to be correlated with breast cancer survival in metastatic setting was done by immunohistochemistry for 70 patients.
Results: Of 173 patients, 90 (52%) received taxane-based therapies, 54 (31.2%) received capecitabine-based therapies, 29 (16.8%) Carboplatin/ Gemcitabine. Although response rate was more significant in taxane rechallenge group (65%) in luminal subgroup, no statistically significance between 2 groups were determined in non-luminal breast cancer subtype. The ORR (in both Luminal and non luminal subtypes) for taxane re-challenge regimen was 58.9%, compared to 50.6% in non-taxane group with no significant difference in ORR between re-challenge and non taxane based treatment at metastatic setting. Non-significant difference was found in PFS between both groups of chemotherapy in metastatic setting with median 13 months in both study arms. Re-challenge showed more significant incidence of neuropathy compared to non taxane group , although more significant GIT and skin toxicity reported in the non-taxane based group (0.001). Correlation of TILs level at diagnosis doesn`t show any significant correlation with primary disease stage, response rate to chemotherapy treatment in the metastatic setting or PFS of metastatic breast cancer and it`s subtypes.
Conclusion: Rechallenging with taxanes in metastatic setting after (neo) adjuvant taxane exposure seems to be a reasonable option with high response rates especially in when rapid response needed in luminal subype.