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Taxane alternatives: efficacy and toxicity
University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, CA
Taxane therapy is widely used for the treatment of metastatic breast cancer (MBC). Many patients, however, do not respond or subsequently relapse due to drug resistance. The use of standard paclitaxel and docetaxel is further limited by the solvents required for parenteral administration of these hydrophobic agents, such as polyethylated castor oil, which can significantly limit dose escalation, increase toxicity, complicate administration of chemotherapy, and alter drug pharmacokinetics. Nanoparticle albumin-bound (nab) paclitaxel is a novel, water-soluble formulation of paclitaxel conjugated to albumin that obviates the need for such toxic solvents. Uptake of this conjugate is facilitated by albumin-mediated transcytosis across endothelial cells into the tumor, thus increasing the effective tumor paclitaxel concentration and reducing systemic toxicity. Clinical trials have demonstrated that nab-paclitaxel is effective for the treatment of MBC, both as monotherapy and in combination regimens. Compared with standard paclitaxel, treatment with nab-paclitaxel is associated with a lower incidence of adverse events, particularly hypersensitivity reactions. Ongoing studies are evaluating the potential of nab-paclitaxel in other combination regimens and for the treatment of drug-resistant MBC.
| Commun Oncol 2008;5(suppl 3):10–16 | full text |  250 kb |