Albumin Bound Paclitaxel is a chemotherapy formulation that has the core component Paclitaxel. This version is absolutely free of solvents. Experts believe that it’s much more effective than the normal Paclitaxel injection. Binding Paclitaxel with Albumin (blood) also helps reduce the risk of hypersensitivity in patients. Another prevalent name is Protein-Bound Paclitaxel.

This drug is marketed under a few brand names including Abraxane and Abra-Bound. Its available dose strength is 100mg per vial.

FDA Approval History:

For Non-Small Cell Lung Cancer: Oct 12, 2012

For Pancreatic Cancer: Sep  6, 2013

For Breast Cancer: Mar  8, 2019

Uses

Protein-Bound Paclitaxel is a taxoid chemotherapeutic lyophilized injection used in the treatment of patients with:

• Metastatic Node-Positive Breast Cancer after the failure of combination therapy with chemotherapeutic agents or evidence of relapse within six months of adjuvant chemotherapy; provided: prior therapy must include an anthracycline.
• Metastatic Adenocarcinoma of the Pancreas, as a combination therapy (first-line treatment) with gemcitabine.
• Advanced Carcinoma of the Ovary, as first-line treatment or subsequent therapy.
• Metastatic or Advanced Non-Small Cell Lung Cancer, as a combination therapy with carboplatin; provided: patients must be ineligible for curative surgery or radiation therapy.
• AIDS-related Kaposi’s Sarcoma associated with lesions in the soft tissues, as a second-line treatment.

Working

Since it is a taxoid and antimicrotubule agent, it works by influencing the microtubule growth in the body. Below are the steps followed by this drug to cause apoptosis (cell death).

• STEP-1
  Microtubules: Microtubules are polymers of tubulin present inside the eukaryotic cells. They are responsible for the functions like cell motility, intracellular transport, and maintenance of cell shape.
• STEP-2
  Albumin Bound Paclitaxel Enters: It interferes with the microtubule growth and hyper-stabilizes their structure. It binds with the subunit of tubulin wherein the new complex loses its ability to disassemble.
• STEP-3
  Cell Death: Due to the shortening and lengthening of microtubules, cell function is affected. This leads to programmed cell death (apoptosis) in cancer cells.

Side Effects

During the therapy period, some patients may experience side effects. That’s because the medicine interferes with the normal functioning of the body. Below are the lists of such effects. Don’t ignore them or other side effects if they last for a long time.

Common side effects

• Cough
• Fever
• Loss of taste
• Pale skin
• Rapid weight gain
• Sneezing
• Chest tightness
• Muscle pain
• Difficulty in urination
• Difficulty in breathing
• Mouth sores
• Lower back pain

Rare side effects

• Bleeding
• Anxiety
• Confusion
• Irritation
• Shallow breathing
• Pain in the joints
• Sweating
• Severe headache
• Pain in the legs
• Swelling of the face
• Skin redness
• Decreased attention

Injection-site reactions

• Pain
• Itching
• Swelling
• Redness
• White spots

Warnings & Precautions

• Pregnancy
  As of now, there is no human clinical trial data to show the risk of this drug in pregnant women. Experts believe that Paclitaxel can have a negative effect on the fetus as per its mechanism of action. Thus, patients are made aware of the potential risks beforehand.
• Nursing
  Since most metabolites of chemotherapy medicines excrete via human milk, nursing must be avoided. However, no clear research shows a direct connection between breastfeeding and Paclitaxel administration.
• Albumin (Human)
  Since the regimen contains albumin (which is human blood), there is an increased risk of viral diseases. For the same, the medical team monitors the frequency and severity of side effects.
• Pediatric use
  It is unclear whether this drug is safe and effective for the treatment of pediatric patients or not.
• Geriatric use
  Most clinical trials of this medicine did not include enough patients aged above 75 years. This is why doctors examine the medical history of older patients carefully and monitor them for complications.

Interactions

Interactions between any two elements can decrease or affect the body’s functioning. That’s why the medical team makes sure to know the health history of the patients before prescribing any new drug. Below are some of such interactions fetched from experts’ data.

Interaction with medicines: Regimens like adalimumab, baricitinib, deferiprone, fosamprenavir, golimumab, infliximab, leflunomide, natalizumab, and ozanimod may interact with Paclitaxel. This can result in complications during the therapy. Other drugs may also have an influence. Dose changes may be done in some cases.

Interaction with diseases: Some diseases are expected to interact with Protein-Bound Paclitaxel. The following may change the working of the drug and cause side effects.

• Conduction disorders
• Peripheral neuropathy
• Hepatic dysfunction
• Myelosuppression

Interaction with alcohol & food: This drug’s functioning is influenced by the consumption of Grapefruit. Concomitant use of the two may lead to weakness, nausea, and hair loss. This is why the oncologist may warn before the therapy regarding grapefruit & its products. Plus, alcohol consumption must be limited or avoided.

Overdose

The recommended dosage of Albumin Bound Paclitaxel is given in the points below. This drug must be administered for over 30 minutes as an IV (intravenous) infusion.

• 260 mg/m² every 3 weeks for Metastatic Breast Cancer
• 100 mg/m² on Days 1, 8, and 15 of each 21-day cycle for NSCLC
• 125 mg/m² on Days 1, 8, and 15 of each 28-day cycle for Adenocarcinoma of the Pancreas.

An overdose on this medicine can lead to severe effects. These can include fainting, irritability, chest pain, heartburn, and shortness of breath. In such a condition, it is important to consult the nearest health practitioner. Immediate supportive care may be necessary in intentional overdose cases.

NOTE: Protein-Bound Paclitaxel is not recommended for self-use. This medicine must not be sold without a doctor’s prescription.