The role of nab™-paclitaxel in managing metastatic breast cancer: a report of three cases

Options for the treatment of metastatic breast cancer (MBC) continue to grow with the advent of signal transduction modulators, new cytotoxics, and new formulations of standard agents. These developments are welcome as a means of further extending progression-free and overall survival, and as a way of allowing us to tailor therapy to characteristics of the individual patient such as the molecular biology of their tumour, treatment history, and performance status. Targeting drug delivery to the tumour is a promising means of increasing the therapeutic index of highly active agents such as the taxanes, and nanoparticle albumin-bound (nab) paclitaxel is one such advance. This paper reviews the clinical trial background for nab-paclitaxel and three individual cases in which its use was judged especially appropriate. These include a patient with prior exposure to anthracycline and docetaxel needing second-line treatment for MBC, a patient requiring first-line treatment following adjuvant anthracycline, and a patient in whom flexible dosing was a potential advantage.