The SNAP trial is a randomized study to detect the best schedule for first-line chemotherapy using nab-paclitaxel to be able to prolong chemotherapy until disease progression. Our aim was by reducing the dose of nab-paclitaxel after induction with three cycles of standard doses could we achieve a progression-free survival similar to or even better than the historical control of single agent docetaxel within the range of seven months. We randomized 258 patients from all over Europe into three different arms with three different schedules of nab-paclitaxel. Each of these arms was then separated and compared to a control arm of docetaxel. One of our schedules resulted in a statistically superior outcome to the historical control arm of docetaxel. In the end， we showed that we can reduce the dose of first-line chemotherapy after the initial induction， thus reducing toxicity but maintaining a high level of activity even better than the historical control.

 

　　Alessandra Gennari介绍说，SNAP试验是一项随机研究，研究的目的是探讨一线化疗中白蛋白紫杉醇初始剂量150 mg/m2 （ days 1，8，15 Q28）三周期诱导化疗后的最佳维持剂量，以实现等效于或甚至优于历史对照组单药多西紫杉醇7个月的无进展生存。该试验将来自欧洲各地的258名患者随机分为三个不同的组，分别给予150 mg/m2  （days 1，15 Q28）、100 mg/m2 （days 1，8，15 Q28）、75 mg/m2 （days 1，8，15，22 Q28）三种不同的白蛋白紫杉醇维持剂量。使用多西紫杉醇一线治疗MBC的PFS（基于AVADO研究）做对照，然后将不同维持剂量组的PFS与之对比，以确定三种方案中的哪一种剂量疗效最好。

 

　　统计结果显示，不同维持剂量组优于历史对照组单药多西他赛，其中100 mg/m2 维持剂量效果最好，明显延长PFS，达到9.0个月，而高剂量150 mg/m2 患者不能耐受。最终结果表明，临床应用中可以减少初始诱导后白蛋白紫杉醇的一线化疗的剂量，选择合适的维持剂量，从而减少毒性，保持高水平的活性甚至达到比历史对照组单药多西他赛更好的疗效。