# Nab-paclitaxel

Source: https://onco.cc/drugs/nab-paclitaxel/  
OnCo record `nab-paclitaxel` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Paclitaxel bound to albumin so it needs no solvent and no steroid premedication. Adding it to gemcitabine and cisplatin looked promising in a small study of bile duct and gallbladder cancer but did not lengthen life in the 452-patient SWOG S1815 trial.

## Summary

Nab-paclitaxel is a solvent-free, albumin-bound formulation of paclitaxel that stabilises microtubules and arrests mitosis; the albumin carrier uses gp60 and SPARC-mediated transport and allows higher doses without the hypersensitivity of Cremophor. It is approved for metastatic breast cancer (United States 2005, European Union 2008), non-small-cell lung cancer (2012) and, with gemcitabine, metastatic pancreatic adenocarcinoma (MPACT, 2013). In biliary tract cancer, a 60-patient MD Anderson and Mayo phase 2 of gemcitabine, cisplatin and nab-paclitaxel (22 percent gallbladder cancer) reported a partial response rate of 45 percent, median progression-free survival of 11.8 months and median overall survival of 19.2 months, which set up SWOG S1815. That randomised phase 3 (441 analysable patients, 16 percent gallbladder cancer) found no overall survival difference between the triplet and gemcitabine plus cisplatin (14.0 versus 13.6 months, hazard ratio 0.91, p 0.41) or progression-free survival (7.5 versus 6.3 months, hazard ratio 0.89); exploratory analyses suggested greater progression-free survival benefit in gallbladder cancer (interaction p 0.01) and in locally advanced disease, but not in overall survival. It therefore has no place in routine biliary treatment and is not licensed or commissioned for it in the UK; several Chinese phase 2 trials continue to test gemcitabine plus nab-paclitaxel backbones with PD-1 antibodies in gallbladder cancer.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-24
- Brand: Abraxane
- Code: ABI-007
- Modality: Albumin-bound taxane (cytotoxic)
- Mechanism: Microtubule stabiliser delivered as 130 nm albumin nanoparticles.
- Approvals: US 2005: Metastatic breast cancer after combination chemotherapy; EU 2008: Metastatic breast cancer; later pancreatic (2013) and non-small-cell lung cancer (2015); US 2013: First-line metastatic pancreatic adenocarcinoma with gemcitabine (MPACT)
- Dosing: Intravenous; 100 mg/m² days 1 and 8 every 21 days with gemcitabine 800 mg/m² and cisplatin 25 mg/m² (S1815 schedule); 125 mg/m² weekly 3 of 4 with gemcitabine in pancreatic cancer

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Protein-bound_paclitaxel
- FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=24d10449-2936-4cd3-b7db-a7683db721e4
- SWOG S1815, JCO 2025: https://doi.org/10.1200/JCO-24-01383
- Shroff et al., JAMA Oncology 2019: phase 2 of gemcitabine, cisplatin and nab-paclitaxel: https://doi.org/10.1001/jamaoncol.2019.0270

## Connected records

- cancers: [Biliary tract cancer (cholangiocarcinoma)](https://onco.cc/cancers/cholangiocarcinoma/), [Breast cancer (all types)](https://onco.cc/cancers/breast-cancer/), [Gallbladder cancer](https://onco.cc/cancers/gallbladder/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/)
- companies: [Bristol Myers Squibb](https://onco.cc/companies/bms/)
- trials: [A Study to See the Effects That a New Combination of the Three Drugs, Nab-paclitaxel, Gemcitabine, and Cisplatin Has on Biliary Tract Cancer](https://onco.cc/trials/nct02632305/), [AK112 Combined With GAP Conversion Therapy for Locally Advanced Gallbladder Cancer](https://onco.cc/trials/nct07767994/), [An Open-label, Single-arm, Multicenter Exploratory Study of Adebrelimab Combined With Gemcitabine and Albumin-bound Paclitaxel as First-line Treatment for Biliary Tract Malignancies](https://onco.cc/trials/nct07668453/), [Anlotinib Plus Nab-Paclitaxels and S-1 for Patients with Advanced Biliary Tract Cancer As Second-Line Treatment](https://onco.cc/trials/nct06662877/), [Camrelizumab and Chemotherapy With or Without Anlotinib as First-line Treatment for Advanced Gallbladder Cancer and Extrahepatic Cholangiocarcinoma](https://onco.cc/trials/nct06901622/), [Combination of Gemcitabine, Albumin-paclitaxel , Sintilimab and Bevacizumab in Unresectable Gallbladder Cancer](https://onco.cc/trials/nct05757336/), [Durvalumab Combined With Chemotherapy Neoadjuvant Therapy of Biliary Tract Cancer](https://onco.cc/trials/nct05640791/), [Gem+Nab-P+LEN+TIS for Advanced Unresectable BTC (GALENT-BT)](https://onco.cc/trials/nct06963060/), [Gemcitabine and Nab-Paclitaxel Combined With Iparomlimab and Tuvorilimab for Advanced Gallbladder Cancer](https://onco.cc/trials/nct07310069/), [Gemcitabine Hydrochloride, Cisplatin, Nab-Paclitaxel, and Durvalumab in Treating Patients With Locally Advanced or Metastatic Gallbladder Cancer](https://onco.cc/trials/nct06591650/), [Gemcitabine, cisplatin and nab-paclitaxel phase 2 (MD Anderson and Mayo)](https://onco.cc/trials/gap-phase2-mdacc/), [Gemcitabine, Cisplatin, Nab-paclitaxel (GAP) and Cemiplimab for Locally Advanced Biliary Tract Cancer (BTC)](https://onco.cc/trials/nct07433673/), [Phase II Study of Iparomlimab and Tuvonralimab (QL1706) in Combination With Albumin-Bound Paclitaxel and Lenvatinib as Second-Line Therapy for Unresectable or Metastatic Biliary Tract Cancer](https://onco.cc/trials/nct07530445/), [RUGB](https://onco.cc/trials/rugb/), [Sintilimab Combined With Ipilimumab (N01) Plus AG as First-line Therapy for uBTC.](https://onco.cc/trials/nct07654530/), [SWOG S1815](https://onco.cc/trials/swog-s1815/)

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