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Albumin-Bound Paclitaxel: A Review of Its Use for the First-Line Combination Treatment of Metastatic Pancreatic Cancer

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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.

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Disclosure

The preparation of this review was not supported by any external funding. Sheridan Hoy is a salaried employee of Adis/Springer. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on this article. Changes resulting from comments received were made by the author on the basis of scientific and editorial merit.

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    Sheridan M. Hoy

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Correspondence to Sheridan M. Hoy.

Additional information

The manuscript was reviewed by: M. Harris, Department of Medical Oncology, Monash Health, East Bentleigh, Victoria, Australia; E. J. Kim, Division of Hematology/Oncology, Department of Internal Medicine, University of California Davis Comprehensive Cancer Center, Sacramento, CA, USA; W. W. Ma, GI Cancers and Drug Development Program, Roswell Park Cancer Institute, Buffalo, NY, USA; E. M. O’Reilly, David M. Rubenstein Center for Pancreas Cancer Research, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA; T. Seufferlein, Department of Internal Medicine I, University of Ulm, Ulm, Germany.

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Hoy, S.M. Albumin-Bound Paclitaxel: A Review of Its Use for the First-Line Combination Treatment of Metastatic Pancreatic Cancer. Drugs 74, 1757–1768 (2014). https://doi.org/10.1007/s40265-014-0291-8

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