Nab-paclitaxel: A flattering facelift

• We examine the pharmacokinetic (PK) and pharmacodynamic (PD) profile of nab-paclitaxel and compare them to conventional paclitaxel.
• Those differences in PK/PD properties could explain the improve in treatment efficacy and reduce side-effects.
• We explain deeply the clinical development of nab-paclitaxel in breast cancer, non-small-cell-lung-cancer, pancreatic cancer and other scenarios as ovarian, melanoma and bladder carcinoma.
• We review different molecules that could have a role as predictive/resistance biomarkers for nab-paclitaxel.

The application of nanotechnology in oncology has increased the efficacy and efficiency of some cytotoxic agents. The paradigm in this field is nab-paclitaxel, a soluble form of paclitaxel that is linked to albumin nanoparticles. The development of nanotechnology as a delivery system for paclitaxel has provided better pharmacokinetic and pharmacodynamic characteristics, neutralizing its hydrophobicity. This procedure significantly improves the treatment of metastatic breast cancer compared to conventional paclitaxel-based therapies, including other type of cancers such as metastatic pancreatic cancer, stage IIIB–IV non-small cell lung cancer (NSCLC) and metastatic melanoma. In these last cases, significant differences were found in primary end-points for patients treated with nab-paclitaxel-based chemotherapy compared to those treated with conventional treatments. The application of nanotechnology in cancer treatment may also improve the efficacy of other known drugs, as a result of improved pharmacokinetic and pharmacodynamic profiles, similarly to paclitaxel.