title: Albumin-bound paclitaxel: a review of its use for the first-line combination treatment of metastatic pancreatic cancer.
abstract: Nanoparticle albumin-bound paclitaxel (Abraxane(®)) [hereafter referred to as nab-paclitaxel] is an intravenously administered microtubule inhibitor. It was developed to avoid the toxicities associated with the polyoxyethylated castor oil solvent (Cremophor) and ethanol vehicles used to overcome paclitaxel's poor aqueous solubility. Nab-paclitaxel is indicated in the EU and the USA as first-line combination therapy with gemcitabine in adults with metastatic adenocarcinoma of the pancreas. Compared with gemcitabine alone, nab-paclitaxel plus gemcitabine significantly prolonged median overall survival, reflecting a 28 % reduction in the risk of death, in adults with metastatic pancreatic cancer participating in a multinational phase III study. In addition, median progression-free survival was significantly prolonged and the objective response rate was significantly higher with nab-paclitaxel plus gemcitabine than with gemcitabine therapy. Nab-paclitaxel plus gemcitabine had a manageable tolerability profile; in general, adverse events in the phase III study were grade 3 or lower and resolved without specific therapy. Neutropenia and peripheral neuropathy were the most frequently reported adverse reactions leading to nab-paclitaxel dose reductions, or to delays in or the withholding of nab-paclitaxel dosing. Peripheral neuropathy was rapidly reversible in the majority of patients following interruptions in nab-paclitaxel administration and a subsequent reduction in the nab-paclitaxel dose. Current evidence indicates that nab-paclitaxel plus gemcitabine is a valuable option for the treatment of metastatic pancreatic cancer.
authors.affiliation: Springer, Private Bag 65901, Mairangi Bay, 0754, Auckland, New Zealand, demail@springer.com.
authors.forename: Sheridan M
authors.initials: SM
authors.lastname: Hoy
mesh_terms: D000068196:Albumin-Bound Paclitaxel; D000418:Albumins / Q000008:administration & dosage / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000379:methods*; D006801:Humans; D009362:Neoplasm Metastasis / Q000188:drug therapy*; D017239:Paclitaxel / Q000008:administration & dosage / Q000627:therapeutic use*; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology*
chemical_list: D000068196:Albumin-Bound Paclitaxel; D000418:Albumins; D000970:Antineoplastic Agents; D017239:Paclitaxel