Nab-paclitaxel
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.
Overview
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.
- Chromosomes at spindle
- Drug blocks division / damages DNA
Microtubule stabiliser delivered as 130 nm albumin nanoparticles.
1.Nab-paclitaxel slips into a pocket on its target.
- AmivantamabApproved
- CamizestrantApproved
- Comprehensive genomic profilingStandard of care
- Liquid biopsy (ctDNA)Standard of care
- LorlatinibApproved
- MRD / molecular residual disease testingEstablished
- ADC payload neutralisersPhase 1
- BGB-16673Phase 3
- Bispecific ADCPhase 3
- BRUIN CLL-321Positive
- CaDAnCe-304Recruiting
- CIRCULATE-Japan (GALAXY / VEGA / ALTAIR)Active
- A clone report from blood at every treatment cycle
- A fast route to the matched drug when it is licensed for another cancer
- A multi-cancer platform trial of adaptive (dose-holiday) therapy
- A national rapid research autopsy network for end-stage cancer
- A standard evolvability score for every tumour
- A standing platform trial that assigns treatment by how the tumour escaped
Background: ADC sequencing, Antigen escape (antigen loss, lineage switch), BCG-unresponsive, Castration-resistant prostate cancer (CRPC), Circulating tumour DNA (ctDNA). Also on OnCo: Resistance atlas · Lines of therapy.
- 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
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2005 | Metastatic breast cancer after combination chemotherapy · FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Abraxane |
| EU | 2008 | Metastatic breast cancer; later pancreatic (2013) and non-small-cell lung cancer (2015) · EMA EPAR: https://www.ema.europa.eu/en/medicines/human/EPAR/abraxane |
| US | 2013 | First-line metastatic pancreatic adenocarcinoma with gemcitabine (MPACT) · FDA label (DailyMed) |
Trials
topTrials recruiting now
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Landmark trials
Latest papers
topQuery for this drug: (TITLE:"Nab-paclitaxel" OR ABSTRACT:"Nab-paclitaxel" OR TITLE:"Abraxane" OR ABSTRACT:"Abraxane" OR TITLE:"ABI-007" OR ABSTRACT:"ABI-007") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Nab-paclitaxel, not a curated reading list.
Similar pages
not linked directly; found by shared links- TermGallbladder cancer in biliary tract cancer trials (eligibility and subgroups)
Shares Gemcitabine and Nab-Paclitaxel Combined With Iparomlimab and Tuvorilimab for Advanced Gallbladder Cancer, 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, Combination of Gemcitabine, Albumin-paclitaxel , Sintilimab and Bevacizumab in Unresectable Gallbladder Cancer, Gemcitabine Hydrochloride, Cisplatin, Nab-Paclitaxel, and Durvalumab in Treating Patients With Locally Advanced or Metastatic Gallbladder Cancer.
- TreatmentTegafur, gimeracil and oteracil (S-1)
Shares Camrelizumab and Chemotherapy With or Without Anlotinib as First-line Treatment for Advanced Gallbladder Cancer and Extrahepatic Cholangiocarcinoma, Anlotinib Plus Nab-Paclitaxels and S-1 for Patients with Advanced Biliary Tract Cancer As Second-Line Treatment, Gallbladder cancer, Cytotoxic chemotherapy.
- TreatmentGemcitabine + cisplatin
Shares Gemcitabine, cisplatin and nab-paclitaxel phase 2 (MD Anderson and Mayo), SWOG S1815, RUGB, Biliary tract cancer (cholangiocarcinoma).
- CancerAmpullary cancer (ampulla of Vater)
Shares 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, A Study to See the Effects That a New Combination of the Three Drugs, Nab-paclitaxel, Gemcitabine, and Cisplatin Has on Biliary Tract Cancer, Biliary tract cancer (cholangiocarcinoma), Gallbladder cancer.
- TreatmentAnlotinib
Shares Camrelizumab and Chemotherapy With or Without Anlotinib as First-line Treatment for Advanced Gallbladder Cancer and Extrahepatic Cholangiocarcinoma, Anlotinib Plus Nab-Paclitaxels and S-1 for Patients with Advanced Biliary Tract Cancer As Second-Line Treatment, Non-small-cell lung cancer.
- TrialA Study to Evaluate the Safety, Tolerability, and Efficacy of BMS-986523 Alone and in Combination With Anti-Cancer Agents in Participants With Advance
Shares Bristol Myers Squibb, Pancreatic ductal adenocarcinoma, Non-small-cell lung cancer.
- TreatmentNavlimetostat
Shares Bristol Myers Squibb, Pancreatic ductal adenocarcinoma, Non-small-cell lung cancer.
- TrialStudy of Izalontamab Brengitecan (BMS-986507) Versus Platinum-Pemetrexed for EGFR-mutated Non-small Cell Lung Cancer After Failure of EGFR TKI Therapy
Shares Bristol Myers Squibb, Cytotoxic chemotherapy, Non-small-cell lung cancer.