Update on the Role of Epothilones in Metastatic Breast Cancer

The role of epothilones in the treatment of locally advanced and metastatic breast cancer remains unclear. While the pivotal studies for ixabepilone were published between 2005 and 2010, and the agent received approval in 2007 from the U.S. Food and Drug Administration, its uptake in routine treatment of breast cancer that is resistant to anthracyclines and taxanes remains inconsistent. The other agents in the class, patupilone and sagopilone, are being studied in a number of cancer types. In this review, the recently published literature on epothilones in various populations and at various dosages is reviewed including the associated adverse event profile and recent biomarker and genomic studies. While the literature has become increasing robust, the precise clinical role for the epothilones in the management of patients with breast cancer remains to be fully defined.