Indications
Nanoparticle Albumin-Bound Paclitaxel (nab-paclitaxel) is a chemotherapy medicine used to treat metastatic breast cancer, advanced non-small cell lung cancer (with Carboplatin), and metastatic cancer of the pancreas (with Gemcitabine). It is used in hospital by cancer specialists.
How It Works
Paclitaxel belongs to the taxane group. It binds to microtubules, tiny structures inside cells that pull chromosomes apart when a cell divides. By locking these structures in place, it stops cancer cells from dividing, and they die. In this form, paclitaxel is attached to tiny particles of albumin (a natural blood protein) instead of an oil-based solvent, so it can be given faster and without the usual allergy-prevention medicines.
Dosage and Administration
Given only by a doctor or nurse in hospital as an infusion into a vein, usually over about 30 minutes. The dose is calculated by the specialist from your body surface area and depends on the cancer type, the treatment plan and your blood counts. It is not interchangeable with other forms of paclitaxel. Blood tests are done before each dose.
Interactions
Medicines that block or speed up the liver enzymes CYP2C8 and CYP3A4 can change paclitaxel levels; examples include Ketoconazole, Clarithromycin, Ritonavir, Gemfibrozil, Rifampicin, Carbamazepine and Phenytoin. Live vaccines should be avoided during treatment. Tell your doctor about all medicines and supplements you take.
Contraindications
It is not given to people with very low neutrophil counts (a type of white blood cell) before treatment, those who are breastfeeding, or those who have had a severe allergic reaction to paclitaxel or albumin.
Side Effects
Common side effects include low blood counts with a higher risk of infection, bleeding and anaemia, hair loss, numbness or tingling in the hands and feet (peripheral neuropathy), tiredness, nausea, diarrhoea, mouth sores, joint and muscle pain, rash and fever. Less common serious effects include lung inflammation, sepsis, heart problems and severe allergic reactions.
Get urgent medical help if you have a fever of 38°C or higher, chills or other signs of infection, breathlessness or a new cough, chest pain, unusual bleeding or bruising, severe diarrhoea or vomiting, or swelling of the face and difficulty breathing.
Pregnancy and Lactation
It can harm an unborn baby. Women should use effective contraception during treatment and for at least 6 months after the last dose; men should use contraception during treatment and for at least 3 months after. Do not breastfeed during treatment and for 2 weeks after the last dose.
Precautions and Warnings
Regular blood tests are needed, and the dose may be delayed or reduced if counts are low or neuropathy is severe. Tell your doctor about liver problems, heart disease or lung disease. Avoid contact with people who have infections, and practise good hand hygiene. Because it contains albumin from human blood, there is a very small theoretical risk of passing on infections.
Overdose
Overdose may cause severe low blood counts, nerve damage and mouth sores. There is no specific antidote; supportive care is given in hospital.
Therapeutic Class
Antineoplastic agent (taxane, microtubule inhibitor).
Storage
Hospital item: store unopened vials as directed on the pack, usually below 25°C in the original carton to protect from light. Prepared infusions are handled by trained hospital staff.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.