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Nab-paclitaxel for breast cancer: a new formulation with an improved safety profile and greater efficacy.

Abstract
Taxanes, paclitaxel and docetaxel, are among the most effective agents used to treat breast cancer. Nab-paclitaxel (ABI-007, Abraxane) is paclitaxel encapsulated in albumin. This differs from the more conventional formulation which uses cremophor to increase the solubility of paclitaxel (CrEL-paclitaxel). In a randomized trial that formed the basis of its regulatory approval in the USA, 3-weekly nab-paclitaxel induced a higher response rate and longer time to progression than CrEL-paclitaxel in patients with metastatic breast cancer. Except for grade 3 sensory neuropathy, nab-paclitaxel was also safer. An interim analysis from a more recent randomized Phase II trial suggests that weekly nab-paclitaxel is more effective and safer than either 3-weekly nab-paclitaxel or 3-weekly docetaxel. The superior efficacy of nab-paclitaxel is presumably due to the improved safety profile, which allows for the administration of higher doses, a greater proportion of which actually reaches the tumor. Observations on the development of nab-paclitaxel have important implications for our understanding of dose response in the use of cytotoxic drugs to treat all forms of cancer. Although it is not yet clear whether nab-paclitaxel can be routinely substituted for CrEL-paclitaxel or docetaxel in breast cancer treatment regimens, it seems highly likely that this will occur within the next 5 years.
AuthorsI Craig Henderson, Vinona Bhatia
JournalExpert review of anticancer therapy (Expert Rev Anticancer Ther) Vol. 7 Issue 7 Pg. 919-43 (Jul 2007) ISSN: 1744-8328 [Electronic] England
PMID17627452 (Publication Type: Journal Article, Review)
Chemical References
  • Albumin-Bound Paclitaxel
  • Albumins
  • Antineoplastic Agents, Phytogenic
  • Paclitaxel
Topics
  • Albumin-Bound Paclitaxel
  • Albumins (adverse effects, therapeutic use)
  • Antineoplastic Agents, Phytogenic (therapeutic use)
  • Breast Neoplasms (drug therapy)
  • Chemistry, Pharmaceutical
  • Clinical Trials as Topic
  • Humans
  • Paclitaxel (adverse effects, therapeutic use)

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