BIG 2-12

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Schedules of nab-Paclitaxel: evaluation of different schedules of nab-paclitaxel for metastatic breast cancer

Schedules of Nab-Paclitaxel in Metastatic Breast Cancer (SNAP)

Nab-Paclitaxel, a nanoparticle albumin-bound taxane (Abraxane®), was developed in an attempt to reduce the toxicity associated with standard taxane administration (caused by the use of chemical solvents) while increasing antitumour efficacy.

Longer first line chemotherapy duration has been associated with a modest, but significant improvement in overall survival and a clinically meaningful and statistically significant improvement in progression-free survival, in metastatic breast cancer patients. Prolonging chemotherapy until disease progression, however, must be weighed against the detrimental effects of continuous chemotherapy delivery. 

The SNAP trial sought to improve the tolerability of prolonged chemotherapy administration strategy by studying alternative treatment schedules, while preserving and possibly improving treatment efficacy in this disease setting.

The SNAP randomized phase II trial evaluated three schedules of nab-Paclitaxel as prolonged chemotherapy administration strategy. Each of three arms were compared to a historical reference of seven-month median progression-free survival (PFS) based on the most recent trial with docetaxel as control arm to determine whether any of the three arms are worthy of further investigation.

258 participants

This study was conducted and sponsored by ETOP IBCSG Partners Foundation, in collaboration with two additional BIG member groups, ICORG and SOLTI. 

Recruitment opened in April 2013.

Primary completion date: May 2016

Study completion date: May 2023

Approximately 41 hospitals from 2 BIG groups in addition to ETOP IBCSG, covering 6 European countries participated.

The SNAP trial demonstrated that alternative nab-paclitaxel maintenance schedules with reduced dosages after a short induction at conventional doses are feasible and active in the first-line treatment of MBC. 

Celgene grant

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