Abraxane in the treatment of ovarian cancer: the absence of hypersensitivity reactions.
BACKGROUND
Paclitaxel is one of the most active agents in the treatment of ovarian carcinoma. However, paclitaxel is solubilized in cremophor, a polyoxyethylated castor oil. Cremophor is allegedly responsible for many paclitaxel-associated hypersensitivity reactions (HSR). Novel agents such as abraxane are solvent free and currently being evaluated to potentially avoid certain patient side effects.


METHODS
We present a case involving a 60-year-old ovarian cancer patient with a significant history of chemotherapy induced HSR. She underwent optimal cytoreductive surgery and began adjuvant chemotherapy in 2000 until she suffered a severe HSR to paclitaxel. In 2002, she was diagnosed with recurrent disease and underwent subsequent treatment with carboplatin, cisplatin, and doxorubicin, all of which resulted in severe HSR. The patient began abraxane therapy in 2005 and has shown no signs of HSR.


CONCLUSIONS
Abraxane is a solvent free taxane, which can be administered without the pre-medications routinely used to prevent HSR. Abraxane may offer paclitaxel HSR patients the benefit of continued taxane treatment. Although the clinical activity of abraxane has not been extensively investigated in ovarian carcinoma, the distinct activity of paclitaxel and good results with recurrent metastatic breast cancer patients suggest additional evaluation with this drug is important.
Micha
John P
JP
Gynecologic Oncology Associates, Hoag Memorial Hospital Cancer Center, 351 Hospital Road, Suite 507, Newport Beach, CA 92663, USA. bram@gynoncology.com
Goldstein
Bram H
BH
Birk
Connie L
CL
Rettenmaier
Mark A
MA
Brown
John V
JV
D000068196:Albumin-Bound Paclitaxel; D000418:Albumins / Q000009:adverse effects / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects / Q000627:therapeutic use; D002291:Carcinoma, Papillary / Q000188:drug therapy / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D018284:Cystadenocarcinoma, Serous / Q000188:drug therapy / Q000601:surgery; D004342:Drug Hypersensitivity / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000601:surgery; D017239:Paclitaxel / Q000009:adverse effects* / Q000627:therapeutic use*
D000068196:Albumin-Bound Paclitaxel; D000418:Albumins; D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel