denosumab + nab-paclitaxel

This is a combination therapy consisting of denosumab (a human monoclonal antibody that binds to RANKL protein) and nab-paclitaxel (a taxoid antineoplastic agent). The GeparX trial investigated this combination in neoadjuvant treatment of early breast cancer. Denosumab (120 mg subcutaneously) was given every 4 weeks for 6 cycles, while nab-paclitaxel (125 mg/m²) was administered either weekly for 12 weeks or on days 1 and 8 every 3 weeks for 4 cycles, followed by epirubicin/cyclophosphamide. The trial found that adding denosumab to anthracycline/taxane-based neoadjuvant chemotherapy did not improve pCR rates (41% vs 43%). However, weekly nab-paclitaxel resulted in significantly higher pCR rates compared to the every-3-weeks schedule (45% vs 39%), particularly in triple-negative breast cancer, though with increased toxicity.