nab-paclitaxel
Overview
Nab-paclitaxel (Abraxane; nanoparticle albumin-bound paclitaxel) is an albumin-formulated taxane that stabilizes microtubules and arrests cells in G2/M. The albumin binding improves solubility and tumor penetration compared to solvent-based paclitaxel. In combination with gemcitabine, it is a standard first-line regimen for metastatic pancreatic adenocarcinoma.
Evidence in the corpus
- KRASG12R-mutant PAAD patients showed enrichment among those receiving neoadjuvant chemotherapy including gemcitabine + nab-paclitaxel followed by resection (32.7% vs 17.9% for KRASG12D, p=0.094), suggesting possible allele-specific chemosensitivity (though this may also reflect selection of borderline-resectable cases) PMID:39214094.
- Gemcitabine/nab-paclitaxel was used in 37% of the curated 1,480-patient MSK PDAC cohort as a dominant first-line regimen; chemotherapy backbone choice between gemcitabine/nab-paclitaxel and FOLFIRINOX was not significantly associated with overall survival in 304 metastatic chemotherapy-treated patients PMID:39753968.
- Cited as an ongoing investigational concurrent regimen combined with SBRT in unresectable locally advanced PAAD (NCT02318095); no efficacy data available in this review PMID:27826200
Resistance mechanisms
- No specific nab-paclitaxel resistance mechanisms reported in the corpus at this time.
Cancer types (linked)
- PAAD — pancreatic adenocarcinoma; dominant first-line regimen (37% of MSK curated cohort) in combination with gemcitabine.
Sources
- PMID:39214094 — McIntyre et al. 2024, Cancer Cell. KRAS allele-specific PDAC outcomes; gemcitabine/nab-paclitaxel enrichment in KRASG12R neoadjuvant patients.
- PMID:39753968 — Varghese et al. 2025, Nature Medicine. MSK PDAC clinicogenomic landscape; gemcitabine/nab-paclitaxel as standard first-line regimen.
- PMID:27826200 — Tchelebi et al. 2016, Semin Radiat Oncol. SBRT in pancreatic cancer review; gemcitabine + nab-paclitaxel + SBRT cited as investigational combination (NCT02318095).
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