Nab-paclitaxel – Albumin-bound Chemotherapy

Nab-paclitaxel (Nanoparticle albumin-bound paclitaxel) is an innovative formulation of paclitaxel where the active substance is bound to human albumin proteins using "nab" technology. This delivery system allows the chemotherapy to be targeted directly to the tumor site while avoiding the use of toxic synthetic solvents.

The mechanism of action is based on paclitaxel’s ability to inhibit cell division by stabilizing microtubules. It prevents their depolymerization, which effectively stalls the cell cycle in the G2 and M phases, leading to cancer cell death. The albumin component exploits natural transport mechanisms: it binds to gp60 receptors on blood vessel walls and the SPARC protein, which is often overexpressed in tumor tissues. This ensures a higher concentration of the drug within the tumor and significantly reduces the risk of severe hypersensitivity reactions associated with conventional paclitaxel.

The drug is administered intravenously and does not require corticosteroid premedication.

Wikipedia page
Nab-paclitaxel

Indications

Nab-paclitaxel is indicated for the treatment of the following types of malignancies:

  • Breast Cancer: metastatic disease after failure of standard combination chemotherapy.
  • Pancreatic Adenocarcinoma: first-line treatment for metastatic disease (in combination with gemcitabine).
  • Non-Small Cell Lung Cancer (NSCLC): first-line treatment for patients who are not candidates for curative surgery or radiation (in combination with carboplatin).

Dosage and administration

Nab-paclitaxel dosing schedules vary according to the specific indication and chemotherapy regimen.

  • Metastatic Breast Cancer: typically 260 mg/m² administered intravenously every 3 weeks.
  • Pancreatic Cancer: 125 mg/m² given on days 1, 8, and 15 of each 28-day cycle.
  • NSCLC: 100 mg/m² administered weekly in combination with carboplatin.
  • Administration: intravenous infusion over 30 minutes. In-line filters are not required during administration.
  • Adjustments: dose reductions are necessary in cases of significant neutropenia or severe sensory neuropathy.

The use of nab-paclitaxel is restricted in the following cases:

  • Hypersensitivity: known allergy to paclitaxel or human albumin.
  • Baseline Neutropenia: absolute neutrophil count (ANC) less than 1,500 cells/mm³.
  • Hepatic Impairment: not recommended for patients with severe liver dysfunction.
  • Pregnancy and Lactation: potential for fetal harm; breastfeeding is contraindicated during therapy.

The most common adverse reactions associated with nab-paclitaxel therapy include:

  • Hematologic: neutropenia (the primary dose-limiting toxicity), anemia, and thrombocytopenia.
  • Neurologic: peripheral sensory neuropathy (numbness, tingling, or pain in hands and feet).
  • Gastrointestinal: nausea, diarrhea, stomatitis, and vomiting.
  • Musculoskeletal: arthralgia and myalgia (joint and muscle pain).
  • General: alopecia (often complete hair loss), fatigue, and asthenia.
  • Dermatologic: nail disorders and skin rash.

Frequently Asked Questions

Nab-paclitaxel is an innovative form of paclitaxel where the active molecules are bound to albumin nanoparticles (nab technology). Unlike conventional paclitaxel, this formulation is free from synthetic solvents (like Cremophor), which significantly reduces the risk of severe allergic reactions and allows for the delivery of higher drug concentrations directly to the tumor site.
Tumor cells actively consume albumin as a nutrient source to fuel their rapid growth. Nab-paclitaxel "tricks" the tumor: the malignant cells ingest the albumin nanoparticles along with the medication. This allows for targeted delivery and deeper drug penetration into tumor tissues compared to standard chemotherapy formulations.
The primary indications include metastatic breast cancer (especially when standard therapy has failed), metastatic pancreatic cancer (in combination with gemcitabine), and non-small cell lung cancer. Its high efficacy in these conditions has been established through extensive clinical trials.
Unlike conventional paclitaxel, nab-paclitaxel generally does not require mandatory premedication with steroids or antihistamines, as the risk of solvent-induced allergic reactions is eliminated. However, the final decision regarding supportive care is made by the attending physician based on the patient's overall health.
Peripheral neuropathy (numbness, tingling, or pain in the hands and feet) is a common side effect. These symptoms usually resolve or improve following a temporary treatment interruption or dose adjustment. Patients should immediately report any sensory changes in their extremities to their healthcare provider.

List of medicines by active substance

-7%
Nab Paclitero 100 mg Hetero
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Hetero

Nab Paclitero

Nab-paclitaxel
100 mg 1 vial
4539₴ 4899₴
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