Safety and efficacy of nab paclitaxel in the treatment of patients with breast cancer

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 influ sion 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.