nab-Paclitaxel in combination with biologically targeted agents for early and metastatic breast cancer

Cancer Treat Rev. 2014 Jun;40(5):614-25. doi: 10.1016/j.ctrv.2014.02.001. Epub 2014 Feb 12.

Abstract

Taxanes are highly active chemotherapeutic agents used in the treatment of early-stage and metastatic breast cancer. Novel formulations have been developed to improve efficacy and decrease toxicity associated with these cytotoxic agents. nab-Paclitaxel is a biologically interactive, solvent-free, 130-nm-sized albumin-bound paclitaxel, developed to avoid the Cremophor vehicle used in solvent-based paclitaxel. Based on a pivotal phase 3 study, nab-paclitaxel was shown to be safely infused at a significantly higher dose of paclitaxel than the doses used with standard paclitaxel therapy, and had a shorter infusion time, no premedication, and higher response rates. It is now approved in the United States for treatment of breast cancer after failure of combination chemotherapy for metastatic disease or relapse within 6 months of adjuvant therapy, and has demonstrated promising efficacy and favorable tolerability. Recently, several phase 2 and 3 studies have suggested a role for nab-paclitaxel in combination with biologically targeted agents for the treatment of early- and late-stage breast cancer. This review will discuss the findings of clinical trials evaluating nab-paclitaxel in combination with biologically targeted therapeutic agents for breast cancer in the neoadjuvant, adjuvant, and metastatic settings.

Keywords: Adjuvant; Bevacizumab; Metastatic breast cancer; Neoadjuvant; Paclitaxel; Trastuzumab; nab-Paclitaxel.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Adult
  • Aged
  • Albumin-Bound Paclitaxel
  • Albumins / adverse effects
  • Albumins / therapeutic use
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bevacizumab
  • Biological Factors / adverse effects
  • Biological Factors / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology*
  • Chemotherapy, Adjuvant
  • Clinical Trials, Phase II as Topic
  • Clinical Trials, Phase III as Topic
  • Disease-Free Survival
  • Early Detection of Cancer
  • Female
  • Humans
  • Infusions, Intravenous
  • Middle Aged
  • Molecular Targeted Therapy / methods*
  • Neoadjuvant Therapy
  • Neoplasm Invasiveness / pathology
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Paclitaxel / adverse effects
  • Paclitaxel / therapeutic use*
  • Prognosis
  • Risk Assessment
  • Survival Analysis
  • Taxoids / adverse effects
  • Taxoids / therapeutic use
  • Trastuzumab
  • Treatment Outcome

Substances

  • Albumin-Bound Paclitaxel
  • Albumins
  • Antibodies, Monoclonal, Humanized
  • Biological Factors
  • Taxoids
  • Bevacizumab
  • Trastuzumab
  • Paclitaxel