Taxanes are highly active chemotherapeutic agents in the treatment of early-stage and metastatic
breast cancer. Novel formulations have been developed to improve efficacy and decrease toxicity associated with these
cytotoxic agents.
nab-paclitaxel is a
solvent free,
albumin-bound 130-nanometer particle formulation of
paclitaxel (
Abraxane(®), Abraxis Bioscience), which was developed to avoid toxicities of the
Cremophor vehicle used in
solvent-based
paclitaxel. In a phase III clinical trial,
nab-paclitaxel demonstrated higher response rates, better safety and side-effect profile compared to conventional
paclitaxel, and improved survival in patients receiving it as second line
therapy. Higher doses can be administered over a shorter infusion time without the need for special infusion sets or pre-medications. It is now approved in the US for treatment of
breast cancer after failure of
combination chemotherapy for metastatic disease or relapse within 6 months of adjuvant
therapy, where prior
therapy included an
anthracycline. Recently, several phase II studies have suggested a role for
nab-paclitaxel as a single agent and in combination with other agents for first-line treatment of metastatic
breast cancer.