Targeted delivery for breast cancer therapy: the history of nanoparticle-albumin-bound paclitaxel.

IMPORTANCE OF THE FIELD: Taxanes are agents for the treatment of breast cancer. Paclitaxel is hydrophobic, and available formulations require polyoxyethylated castor oil, Cremphor EL (CrEL) and an ethanol vehicle to allow parental administration. Nanoparticle albumin-bound paclitaxel (nab-P) is a CrEL-free formulation of paclitaxel. The human albumin-stabilized paclitaxel particles have a size of approximately 130 nm, which allows intravenous infusion without capillary blockage.

AREAS COVERED IN THIS REVIEW: Efficacy and safety of nab-P in breast cancer has been compared with paclitaxel and docetaxel in large Phase III and II trials. Additionally, the efficacy and safety of nab-P have been investigated in other single-arm clinical trials, in early and advanced disease.

WHAT THE READER WILL GAIN: Preclinical and clinical development of the drug across all clinical trials published so far, the approved clinical indications, the benefits of this taxane formulation and a look into the future with emphasis on the application in specific subtypes of breast cancer.

TAKE HOME MESSAGE: nab-P has been approved for the treatment of metastatic breast cancer in patients who have failed first-line treatment for metastatic disease and for whom standard, anthracycline-containing therapy is not indicated and represents one of most authoritative and sophisticated applications of nanotechnology in cancer treatment so far.