Ixabepilone, a new class of chemotherapy for advanced breast cancer

Ixabepilone is a member of a new class of cytotoxic agents, the epothilones, developed as a novel therapy for patients who are resistant to anthracyclines, taxanes or the fluorinated pyrimidines (ie, capecitabine). The efficacy and safety of ixabepilone as a single agent or in combination with capecitabine has been demonstrated in locally advanced and metastatic breast cancer. Based on the positive results obtained in phase II and III clinical trials, ixabepilone is FDA approved both in combination with capecitabine for patients with metastatic or locally advanced breast cancer after failure of an anthracycline and a taxane, or as monotherapy for patients with metastatic or locally advanced breast cancer after failure of an anthracycline, a taxane, and capecitabine. Adverse events associated with ixabepilone therapy, when administered as a single-agent or in combination with capecitabine, are manageable. Common adverse events include: hematologic toxicity, peripheral neuropathy, fatigue/asthenia, myalgia/arthralgia, alopecia, nausea, stomatitis/mucositis, and vomiting. Nurses have an essential role in recognizing and managing such adverse events to ensure that patients derive the maximum benefit from ixabepilone therapy.