Algorithms for the treatment of locally advanced metastatic breast cancer (mBC) provide for the consistent use of chemotherapy, and appointment of targeted therapy if necessary. Epothilone ixabepilone is a microtubule stabilizer approved as monotherapy and in combi- nation with capecitabine for the treatment of mBC in patients with proven resistance to anthracyclines and taxanes. Chemotherapy and hormonal therapy form the basis of mBC treatment. The epothilone class of drugs is characterized by efficacy and safety in patients with disease progression during chemotherapy. In phase III studies, ixabepilone increased progression-free survival and overall response rates with a controlled toxicity profile. Recent subpopulation analyzes of large pooled datasets have shown improvements in progression-free survival and overall survival with ixabepilone in patients with triple-negative breast cancer and in patients who relapsed within 12 months of prior treatment. Additional study parameters for ixabepilone therapy discussed here include adjuvant therapy, weekly dosing regimens, and the use of ixabepilone in new treatment combinations. As with other microtubule stabilizers, treatment with ixabepilone may lead to peripheral neuropathy, but evidence-based treatment strategies may prevent these symptoms. Dose reduction did not appear to affect the efficacy of ixabepilone in combination with capecitabine. The inclusion of ixabepilone in individual treatment plans may increase progres- sion-free survival in a population of patients with previous therapy failure.

Keywords: ixabepilone, drug resistance, chemotherapy, breast cancer