Nab-paclitaxel: potential for the treatment of advanced pancreatic cancer
Marwan Al-Hajeili,1,2 Asfar S Azmi,3 Minsig Choi2
1Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 2Department of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA; 3Department of Pathology, Wayne State University, Detroit, MI, USA
Abstract: Advanced pancreatic adenocarcinoma is a deadly disease and is considered incurable. For the past two decades, gemcitabine remained the major chemotherapeutic drug with modest clinical benefit. Many chemotherapy and targeted agents were combined with gemcitabine but failed to demonstrate improvement in pancreatic cancer (PC) survival. Taxanes (paclitaxel, docetaxel) were introduced in the clinic as anti-microtubule agents and showed activity against PC cells in vitro; however, clinical efficacy was limited. Nab-paclitaxel (Abraxane) is an albumin-bound paclitaxel that has shown clinical activity in advanced breast and lung cancer. Recently, nab-paclitaxel was tested in a large Phase III clinical trial in combination with gemcitabine for the treatment of advanced PC. The data showed that the addition of nab-paclitaxel improved the response rate (7% in gemcitabine alone versus 23% in combination), progression-free survival (from 3.7 months to 5.5 months), and overall survival from 6.7 months to 8.5 months, compared to single agent gemcitabine. Through this review, we provide the preclinical and clinical progress in the development of nab-paclitaxel for the treatment of metastatic PC.
Keywords: pancreatic adenocarcinoma, nab-paclitaxel, abraxane, gemcitabine
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