II. Indications

  1. FDA Approved (part of combination protocols)
    1. Non-Small Cell Lung Cancer (non-operative, not amenable to Radiation Therapy)
    2. Pancreatic Cancer (metastatic)
    3. Breast Cancer (metastatic, refractory or relapsing)
  2. Off-Label
    1. Metastatic Melanoma
    2. Ovarian Cancer or associated cancers (fallopian tube cancer, primary peritoneal cancer)

III. Contraindications

  1. Hepatic Impairment (relative contraindication)
    1. Increased toxicity risk

IV. Mechanism

  1. See Mitotic Inhibitor Chemotherapy
  2. Albumin-Bound Paclitaxel is a injection formulation of nanoparticles
    1. Removes toxicity inducing solvents, improving Paclitaxel safety and Therapeutic Index
  3. Paclitaxel is a taxane Antineoplastic Agent
    1. Derived from extract of the Pacific yew tree (Taxus brevifolia)
  4. Paclitaxel has antineoplastic activity as a an antitubulin agent
    1. Binds and stabilizes tubulin
    2. Inhibits microtubule disassembly
    3. Results in cell cycle arrest in G2/M phase
  5. Paclitaxel induces apoptosis
    1. Binds and blocks apoptosis inhibitor Protein Bcl-2 (B-cell Leukemia 2)

V. Medications

  1. Protein-Bound Paclitaxel for IV Infusion: 100 mg Vial

VI. Dosing

  1. See other references for disease specific dosing protocols

VII. Adverse Effects

  1. Hypersensitivity Reaction
  2. Myelosuppression (Bone Marrow suppression) with Neutropenia
  3. Peripheral Neuropathy (sensory)
  4. Future impaired fertility
  5. Alopecia
  6. Cardiac conduction abnormalities

VIII. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count

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