How Ixabepilone (Ixempra) Works

Ixabepilone is one of several chemotherapy drugs used in the US, which is included in the group of drugs known as antimicrotubule agents or epothilone B analogs. “Ixabepilone (Ixempra) is a member of a new class of cytotoxic agents, known as epothilones. Epothilones promote tubulin polymerization in vitro and demonstrate antitumor activity,” explain the author of the study “Ixabepilone (Ixempra), a Therapeutic Option for Locally Advanced or Metastatic Breast Cancer.” This means that ixabepilone binds directly to ß-tubulin subunits on microtubules, which results in the suppression of microtubule function, and consequently a process of cancer cells death called apoptosis.

The drug is used specifically for patients with breast cancer, but it is being studied for other indications. It is administered intravenously, depending the dosage on factors like patient’s height and weight, general health or other health problems, and the subtype of breast cancer. In more than 30% of the cases, patients experience peripheral neuropathy, weakness, pain in the muscles and joints, nausea, vomiting, and low white blood cell count as side effects, while more rare problems include mouth sores, diarrhea, muscle and bone pain, poor appetite, constipation, abdominal pain, or headache.

Ixabepilone (Ixempra) For Breast Cancer

Ixabepilone was approved by the US Food and Drug Administration (FDA) on October 16, 2007 to be used in combination with capecitabine for the treatment of patients with metastatic or locally advanced breast cancer, and whose tumors are either resistant to treatment with an anthracycline and a taxane, or whose cancer is taxane resistant and for whom further anthracycline therapy is contraindicated. The second indication of the drug is as mono-therapy for patients with metastatic or locally advanced breast cancer whose tumors are resistant or refractory to anthracyclines, taxanes, and capecitabine. Commercialized under the brand name Ixempra™, the drug is produced by Bristol-Myers Squibb.

The safety and effectiveness of ixabepilone was evaluated in two clinical trials, which were used to justify the drug’s approval. “The median PFS [progression-free survival] was 5.7 months in the combination arm and 4.1 months in the capecitabine alone arm. Patients in the combination arm also had an increased objective tumor response rate,” note the National Cancer Institute about the first trial, which included 752 patients and focused on the combined use of ixabepilone. The use of the drug as mono-therapy was evaluated in a clinical trial with 126 patients. “The objective response rate based on independent radiologic review was 12.4 percent (95 percent CI: 6.9, 19.9). The objective response rate based on investigator assessments was 18.3 percent (95 percent CI: 11.9, 26.1). The median response duration was 6.0 months (95 percent CI: 5.0, 7.6).”

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