Targeted chemotherapy with nanoparticle albumin-bound paclitaxel (-paclitaxel) in metastatic breast cancer: which benefit for which patients?

The therapeutic goals in metastatic breast cancer (MBC) remain palliative in nature, aimed at controlling symptoms, improving or maintaining quality of life and prolonging survival. The advent of new drugs and new formulations of standard agents has led to better outcomes in patients with advanced o...

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Main Authors: Raffaella Palumbo, Federico Sottotetti, Antonio Bernardo
Format: Article
Language:English
Published: SAGE Publishing 2016-05-01
Series:Therapeutic Advances in Medical Oncology
Online Access:https://doi.org/10.1177/1758834016639873
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author Raffaella Palumbo
Federico Sottotetti
Antonio Bernardo
author_facet Raffaella Palumbo
Federico Sottotetti
Antonio Bernardo
author_sort Raffaella Palumbo
collection DOAJ
description The therapeutic goals in metastatic breast cancer (MBC) remain palliative in nature, aimed at controlling symptoms, improving or maintaining quality of life and prolonging survival. The advent of new drugs and new formulations of standard agents has led to better outcomes in patients with advanced or metastatic disease. These developments have also allowed a tailored therapeutic approach, in which the molecular biology of the tumour, the treatment history, and patient attitudes are taken into account in the decision-making process. Targeting drug delivery to the tumour is a promising mean of increasing the therapeutic index of highly active agents such as the taxanes, and nanoparticle albumin-bound paclitaxel ( nab -paclitaxel), the first nanotechnology-based drug developed in cancer treatment, is one such advance. Data from randomized trials support the efficacy of single-agent nab -paclitaxel as first-line and further treatment lines in MBC at the registered 3-weekly schedule of 260 mg/m 2 , but emerging evidence suggests its activity as a weekly regimen or combined with other agents in various clinical scenarios. Thus, nab -paclitaxel seems to offer flexibility in terms of dosing schedules, allowing physicians to tailor the dose according to different clinical situations. This paper reviews the clinical trial background for nab -paclitaxel in MBC, focusing on specific ‘difficult-to-treat’ patient populations, such as taxane-pretreated or elderly women, as well as those with triple-negative, HER2-positive and poor-prognostic-factors disease. Moving beyond evidence-based information, ‘real life’ available experiences are also discussed with the aim of providing an update for daily clinical practice.
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spelling doaj.art-edfc3eb7bd0d46baa42c94a1e0c77e882022-12-22T02:52:53ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592016-05-01810.1177/1758834016639873Targeted chemotherapy with nanoparticle albumin-bound paclitaxel (-paclitaxel) in metastatic breast cancer: which benefit for which patients?Raffaella PalumboFederico SottotettiAntonio BernardoThe therapeutic goals in metastatic breast cancer (MBC) remain palliative in nature, aimed at controlling symptoms, improving or maintaining quality of life and prolonging survival. The advent of new drugs and new formulations of standard agents has led to better outcomes in patients with advanced or metastatic disease. These developments have also allowed a tailored therapeutic approach, in which the molecular biology of the tumour, the treatment history, and patient attitudes are taken into account in the decision-making process. Targeting drug delivery to the tumour is a promising mean of increasing the therapeutic index of highly active agents such as the taxanes, and nanoparticle albumin-bound paclitaxel ( nab -paclitaxel), the first nanotechnology-based drug developed in cancer treatment, is one such advance. Data from randomized trials support the efficacy of single-agent nab -paclitaxel as first-line and further treatment lines in MBC at the registered 3-weekly schedule of 260 mg/m 2 , but emerging evidence suggests its activity as a weekly regimen or combined with other agents in various clinical scenarios. Thus, nab -paclitaxel seems to offer flexibility in terms of dosing schedules, allowing physicians to tailor the dose according to different clinical situations. This paper reviews the clinical trial background for nab -paclitaxel in MBC, focusing on specific ‘difficult-to-treat’ patient populations, such as taxane-pretreated or elderly women, as well as those with triple-negative, HER2-positive and poor-prognostic-factors disease. Moving beyond evidence-based information, ‘real life’ available experiences are also discussed with the aim of providing an update for daily clinical practice.https://doi.org/10.1177/1758834016639873
spellingShingle Raffaella Palumbo
Federico Sottotetti
Antonio Bernardo
Targeted chemotherapy with nanoparticle albumin-bound paclitaxel (-paclitaxel) in metastatic breast cancer: which benefit for which patients?
Therapeutic Advances in Medical Oncology
title Targeted chemotherapy with nanoparticle albumin-bound paclitaxel (-paclitaxel) in metastatic breast cancer: which benefit for which patients?
title_full Targeted chemotherapy with nanoparticle albumin-bound paclitaxel (-paclitaxel) in metastatic breast cancer: which benefit for which patients?
title_fullStr Targeted chemotherapy with nanoparticle albumin-bound paclitaxel (-paclitaxel) in metastatic breast cancer: which benefit for which patients?
title_full_unstemmed Targeted chemotherapy with nanoparticle albumin-bound paclitaxel (-paclitaxel) in metastatic breast cancer: which benefit for which patients?
title_short Targeted chemotherapy with nanoparticle albumin-bound paclitaxel (-paclitaxel) in metastatic breast cancer: which benefit for which patients?
title_sort targeted chemotherapy with nanoparticle albumin bound paclitaxel paclitaxel in metastatic breast cancer which benefit for which patients
url https://doi.org/10.1177/1758834016639873
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