Cancer Treatment Today

Abraxane (nab-paclitaxel) is an albumin-bound, 130-nm particle form of paclitaxel that was developed to avoid cremophor/ethanol-associated toxicities associated with the parent compound. Abraxane is FDA-approved for the treatment of breast cancer after the failure of combination chemotherapy for metastatic disease or relapse within 6 months of adjuvant chemotherapy. Abraxane has been evaluated as a single agent and in combinations, including with carboplatin. Ongoing and future strategies with Abraxane include combinations with novel targeted agents and incorporation into the management of early-stage NSCLC.

A comparative phase III trial was presented in 2010 ASCO. PR or CR was demonstrated in 170 patients (33%) receiving Abraxane versus demonstrated response in 132 patients (25%) treated with the paclitaxel combination, while patients receiving Taxol had an ORR of 25%. In addition, analysis of the squamous cell carcinoma subset, showed a 67% improvement in those who received Abraxane versus those who received Taxol.

Almost all exploration has been in advanced disease. Ongoing and future strategies with Abraxane include combinations with novel targeted agents and incorporation into the management of early-stage NSCLC. To my knowledge, there have not been published studies on the use of Abraxane with carboplatin for adjuvant therapy of lung cancer, and none are listed on clinicaltrials.gov.

Rizvi N, Azzoli C, Miller V, et al. Phase I/II study of ABI-007 as first line chemotherapy in advanced non-small cell lung cancer. J Clin Oncol 2006;24:Abstract # 7105.

Green MR, Manikhas GM, Orlov S, et al. Abraxane, a novel Cremophor-free, albumin-bound particle form of paclitaxel for the treatment of advanced non-small-cell lung cancer. Ann Oncol 2006;17:1263-1268.

Hawkins MJ, Georgy M, Makhson A, et al. Dose escalation study of nab-paclitaxel followed by carboplatin as first-line therapy in advanced non-small cell lung cancer. J Clin Oncol 2006;24: 397s, Abstract # 7132.

Allerton JP, Hagenstad CT, Webb RT, et al. A phase II evaluation of the combination of paclitaxel protein-bound and carboplatin in the first-line treatment of advanced non-small cell lung cancer. J Clin Oncol 2006;24:395s, Abstract # 7127.

Sandler A, Gray R, Perry MC, et al: Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med 2006;355:2542-2550.

Reynolds C, et al. Nab-Paclitaxel/Carboplatin/Bevacizumab in Advanced Non-Squamous NSCLC. Proceedings of the Chemotherapy Foundation Symposium XXIV. New York, New York. November 12, 2006.

Greco A, et al. Albumin Bound Paclitaxel Wkly+Carboplatin: First-Line Therapy for Advanced NSCLC. Proceedings of the Chemotherapy Foundation Symposium XXIV. New York, New York. November 12, 2006.
Hawkins MJ, Georgy M, Makhson A, et al. Dose escalation study of nab-paclitaxel followed by carboplatin as first-line therapy in advanced non-small cell lung cancer. J Clin Oncol 2006;24: 397s, Abstract # 7132.

Allerton JP, Hagenstad CT, Webb RT, et al. A phase II evaluation of the combination of paclitaxel protein-bound and carboplatin in the first-line treatment of advanced non-small cell lung cancer. J Clin Oncol 2006;24:395s, Abstract # 7127.

Sandler A, Gray R, Perry MC, et al: Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med 2006;355:2542-2550.

Reynolds C, et al. Nab-Paclitaxel/Carboplatin/Bevacizumab in Advanced Non-Squamous NSCLC. Proceedings of the Chemotherapy Foundation Symposium XXIV. New York, New York. November 12, 2006.

Greco A, et al. Albumin Bound Paclitaxel Wkly+Carboplatin: First-Line Therapy for Advanced NSCLC. Proceedings of the Chemotherapy Foundation Symposium XXIV. New York, New York. November 12, 2006.

M. Socinski et al, Weekly nab-Paclitaxel in Combination With Carboplatin Versus Solvent-Based Paclitaxel Plus Carboplatin as First-Line Therapy in Patients With Advanced NonSmall-Cell Lung Cancer: Final Results of a Phase III Trial. JCO June 10, 2012 vol. 30 no. 17 2055-2062

2.NCCN, NSCL-F, 3 2015