Breast cancer is a malignant disease caused by cells in the breast growing out of control, causing symptoms like a new breast lump or mass, swelling of all or part of a breast, skin irritation or dimpling, breast or nipple pain, nipple retraction, redness, scaliness, or thickening of the nipple or breast skin, and nipple discharge other than breast milk. Malignant breast cancer — both invasive and non-invasive — was diagnosed in about 291,000 women and 2,350 men in 2015 in the U.S., according to the American Breast Cancer Foundation.

Despite the high incidence of the disease, there are treatment options. Local treatment is the name given to approaches designed to treat the cancer without harming the rest of the body, such as surgery and radiation therapy, while systemic treatments, like chemotherapy, hormone therapy, targeted therapy, and bone-directed therapy are focused on the use of drugs to reach cancer cells anywhere in the body. Along with docetaxel, albumin-bound paclitaxel (Nab-Paclitaxel or Abraxane) is one of the most common types of chemotherapy drugs used for the treatment of breast cancer.

How Albumin-Bound Paclitaxel Works

Albumin-bound paclitaxel is a chemotherapy drug from the class of taxanes, used as standard treatment of patients with metastatic breast cancer. Chemotherapy can be used alone before a surgery as co-adjuvant therapy, or after the surgery as adjuvant therapy. As a type of mitotic inhibitor and a type of antimicrotubule agent, the drug was developed as a way of decreasing the side effects related to previously used taxanes with the same potential to kill cancer cells.

Drugs like albumin-bound paclitaxel function by stopping a process of cell division known as mitosis. The drug acts in the cellular structures that help move chromosomes during mitosis — the microtubules — in order to stop mitosis and, consequently, block the cancer cell growth.

“The proposed mechanism of drug delivery involves, in part, glycoprotein 60-mediated endothelial cell transcytosis of paclitaxel-bound albumin and accumulation in the area of tumor by albumin binding to SPARC (secreted protein, acidic and rich in cysteine),” noted the authors of the study “Albumin-bound paclitaxel: a next-generation taxane.”

Albumin-Bound Paclitaxel for Breast Cancer

“On Jan. 7, 2005, the U.S. Food and Drug Administration approved paclitaxel protein-bound particles for injectable suspension, albumin-bound (Abraxane, a trademark of American BioScience Inc.) for treatment of breast cancer after failure of combination chemotherapy for metastatic disease or relapse within six months of adjuvant chemotherapy,” according to the National Cancer Institute. “Nanoparticle paclitaxel is also called paclitaxel albumin-stabilized nanoparticle formulation. Prior therapy should have included an anthracycline unless clinically contraindicated.”

The approval of the drug was based on two single arm studies with 106 patients and a multicenter randomized trial with 460 patients who suffered from metastatic breast cancer. The research demonstrated the effectiveness of albumin-bound paclitaxel, being the recommended dose defined as 260 mg/m2 of nanoparticle paclitaxel intravenously over 30 minutes every three weeks. Clinically important adverse events reported include neutropenia, anemia, infections, hypersensitivity reactions, sensory neuropathy, edema, nausea, vomiting, diarrhea, and mucositis.

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