Nab-paclitaxel

Nab-paclitaxel (Abraxane) is a taxane-type chemotherapy medicine used to treat breast cancer. It is paclitaxel (Taxol) wrapped in the protein albumin. The albumin allows the medicine to be given in water. This lessens the risk of an allergic reaction, which is common with taxanes like paclitaxel or docetaxel.

Taxanes must be put in a solvent, a sort of wrapper, so they can dissolve in your body. Some of the side effects of paclitaxel are associated with its wrapper rather than with the medicine itself. So, a different type of paclitaxel, wrapped in protein, was developed. This medicine is called nanoparticle albumin bound-paclitaxel, or nab-paclitaxel. Like paclitaxel, nab-paclitaxel can be used to treat all stages of breast cancer.

Other names for this medicine include ABI-007, nanoparticle albumin-bound paclitaxel, paclitaxel albumin-stabilized nanoparticle formulation, and protein-bound paclitaxel.

How nab-paclitaxel works

Nab-paclitaxel stalls tumor growth by stopping cell division. It is cell-cycle specific, which means it attacks the cells during specific points in their growth.

Who gets nab-paclitaxel

Nab-paclitaxel is used to treat metastatic breast cancer after combination chemotherapy with an anthracycline has stopped working, or when the cancer has come back within 6 months of treatment after surgery for early-stage breast cancer. It is also sometimes used for localized breast cancer, either before or after surgery.

Nab-paclitaxel may be used in people with all types of breast cancer, including triple-negative metastatic breast cancer.

How nab-paclitaxel is given

Nab-paclitaxel is given by vein using an IV, either alone or with other treatments, once every 3 weeks or once per week. It is given in less than 30 minutes, compared to the up to 3 hours it takes to get regular paclitaxel. You may receive medicine to prevent nausea before you begin treatment.

Your doctor will recommend how many cycles you should have.

Side effects and things to remember

The side effects of nab-paclitaxel are similar to those of regular paclitaxel, but nab-paclitaxel has a smaller risk of allergic reaction.

Common side effects include:

• Neutropenia (low white blood cell count, which carries a risk of infection)
• Anemia, or a low red blood cell count
• Low platelets, the cell fragments that help your blood to clot
• Neuropathy, numbness or tingling in the hands and feet
• Allergic reactions
• Hair loss
• Abnormal heartbeat
• Fatigue
• Joint and muscle pain
• Rash
• Nausea and vomiting
• Infections
• Diarrhea
• Dehydration
• Swelling in the hands or feet

Other side effects include:

• Loss of appetite
• Menopausal symptoms
• Mouth sores
• Vision problems
• Kidney problems
• Constipation
• Difficulty breathing

You should not get nab-paclitaxel if your white blood cell count is low. If you have liver problems, your doctor will likely start out with a lower dose or recommend a different treatment for you.

Before starting nab-paclitaxel, tell your doctor about any medicines you are taking, including vitamins, herbal supplements and over-the-counter medicines. Also let your providers know about all your medical conditions, including liver, heart or kidney problems. Tell your doctor right away if you develop a fever because it could signal an infection.

You should avoid becoming pregnant while you are receiving nab-paclitaxel. Tell your doctor right away if you become pregnant or may be pregnant while you are undergoing treatment.

Your doctor, pharmacist or nurse can help you manage your side effects. You can also go to our section on Side Effects for more information.