{"entity":{"id":"nab-paclitaxel","kind":"drug","name":"Nab-paclitaxel","aka":[],"tldr":"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.","status":"approved","asOf":"2026-09-24","wikipedia":"https://en.wikipedia.org/wiki/Protein-bound_paclitaxel","links":[{"label":"FDA label (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=24d10449-2936-4cd3-b7db-a7683db721e4"},{"label":"SWOG S1815, JCO 2025","url":"https://doi.org/10.1200/JCO-24-01383"},{"label":"Shroff et al., JAMA Oncology 2019: phase 2 of gemcitabine, cisplatin and nab-paclitaxel","url":"https://doi.org/10.1001/jamaoncol.2019.0270"}],"tags":[],"related":[],"cancers":["gallbladder","cholangiocarcinoma","pancreatic","breast-cancer","nsclc"],"sections":[],"technologies":["cytotoxic-chemotherapy"],"targets":[],"drugs":[],"companies":["bms"],"institutions":[],"pathways":[],"terms":[],"trials":["swog-s1815","gap-phase2-mdacc","rugb"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"brand":"Abraxane","code":"ABI-007","modality":"Albumin-bound taxane (cytotoxic)","mechanism":"Microtubule stabiliser delivered as 130 nm albumin nanoparticles.","approvals":[{"region":"US","year":2005,"indication":"Metastatic breast cancer after combination chemotherapy","note":"FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=24d10449-2936-4cd3-b7db-a7683db721e4"},{"region":"EU","year":2008,"indication":"Metastatic breast cancer; later pancreatic (2013) and non-small-cell lung cancer (2015)","note":"EMA EPAR: https://www.ema.europa.eu/en/medicines/human/EPAR/abraxane"},{"region":"US","year":2013,"indication":"First-line metastatic pancreatic adenocarcinoma with gemcitabine (MPACT)","note":"FDA label (DailyMed)"}],"mechanismSteps":[],"dosing":{"route":"Intravenous","schedule":"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","monitoring":"Neutrophils, peripheral neuropathy"},"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/nab-paclitaxel/","neighbours":{"cancer":[{"id":"cholangiocarcinoma","kind":"cancer","name":"Biliary tract cancer (cholangiocarcinoma)","route":"/cancers/cholangiocarcinoma/"},{"id":"breast-cancer","kind":"cancer","name":"Breast cancer (all types)","route":"/cancers/breast-cancer/"},{"id":"gallbladder","kind":"cancer","name":"Gallbladder cancer","route":"/cancers/gallbladder/"},{"id":"nsclc","kind":"cancer","name":"Non-small-cell lung cancer","route":"/cancers/nsclc/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"}],"company":[{"id":"bms","kind":"company","name":"Bristol Myers Squibb","route":"/companies/bms/"}],"trial":[{"id":"nct02632305","kind":"trial","name":"A Study to See the Effects That a New Combination of the Three Drugs, Nab-paclitaxel, Gemcitabine, and Cisplatin Has on Biliary Tract Cancer","route":"/trials/nct02632305/"},{"id":"nct07767994","kind":"trial","name":"AK112 Combined With GAP Conversion Therapy for Locally Advanced Gallbladder Cancer","route":"/trials/nct07767994/"},{"id":"nct07668453","kind":"trial","name":"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","route":"/trials/nct07668453/"},{"id":"nct06662877","kind":"trial","name":"Anlotinib Plus Nab-Paclitaxels and S-1 for Patients with Advanced Biliary Tract Cancer As Second-Line Treatment","route":"/trials/nct06662877/"},{"id":"nct06901622","kind":"trial","name":"Camrelizumab and Chemotherapy With or Without Anlotinib as First-line Treatment for Advanced Gallbladder Cancer and Extrahepatic Cholangiocarcinoma","route":"/trials/nct06901622/"},{"id":"nct05757336","kind":"trial","name":"Combination of Gemcitabine, Albumin-paclitaxel , Sintilimab and Bevacizumab in Unresectable Gallbladder Cancer","route":"/trials/nct05757336/"},{"id":"nct05640791","kind":"trial","name":"Durvalumab Combined With Chemotherapy Neoadjuvant Therapy of Biliary Tract Cancer","route":"/trials/nct05640791/"},{"id":"nct06963060","kind":"trial","name":"Gem+Nab-P+LEN+TIS for Advanced Unresectable BTC (GALENT-BT)","route":"/trials/nct06963060/"},{"id":"nct07310069","kind":"trial","name":"Gemcitabine and Nab-Paclitaxel Combined With Iparomlimab and Tuvorilimab for Advanced Gallbladder Cancer","route":"/trials/nct07310069/"},{"id":"nct06591650","kind":"trial","name":"Gemcitabine Hydrochloride, Cisplatin, Nab-Paclitaxel, and Durvalumab in Treating Patients With Locally Advanced or Metastatic Gallbladder Cancer","route":"/trials/nct06591650/"},{"id":"gap-phase2-mdacc","kind":"trial","name":"Gemcitabine, cisplatin and nab-paclitaxel phase 2 (MD Anderson and Mayo)","route":"/trials/gap-phase2-mdacc/"},{"id":"nct07433673","kind":"trial","name":"Gemcitabine, Cisplatin, Nab-paclitaxel (GAP) and Cemiplimab for Locally Advanced Biliary Tract Cancer (BTC)","route":"/trials/nct07433673/"},{"id":"nct07530445","kind":"trial","name":"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","route":"/trials/nct07530445/"},{"id":"rugb","kind":"trial","name":"RUGB","route":"/trials/rugb/"},{"id":"nct07654530","kind":"trial","name":"Sintilimab Combined With Ipilimumab (N01) Plus AG as First-line Therapy for uBTC.","route":"/trials/nct07654530/"},{"id":"swog-s1815","kind":"trial","name":"SWOG S1815","route":"/trials/swog-s1815/"}]}}