The study clearly demonstrated a survival advantage for nab-paclitaxel with an improved toxicity profile. In 2009 a phase II randomized study [26] compared three week docetaxel 100mg/m2 with three week nab-paclitaxel 300mg/m2, weekly nab-paclitaxel 100mg/sqm and weekly nab-paclitaxel 150mg/sqm. The 150 nab-paclitaxel

weekly schedule provided the best PFS (>5 months) which resulted to be statistically significant. An update of this study published by Gradishar et al. in 2012 demonstrated a median overall survival (OS) of 33.8 months which statistically overcame the other treatment arms. All together these data demonstrated that nab-paclitaxel is superior Inhibitors,research,lifescience,medical to CrEL-paclitaxel in the three week schedule and that Inhibitors,research,lifescience,medical nab-paclitaxel at weekly 150 schedule provides

an impressive long term survival [27]. Recently, nab-paclitaxel was administered in combination with biological agents in the treatment of mBC. In detail, a safety analysis of the first ten enrolled patients treated for at least one cycle of the initial doses of nab-paclitaxel Inhibitors,research,lifescience,medical (125mg/m2 i.v. on days 1, 8, and 15 every 28 days) in combination with lapatinib (1,250mg orally once daily on a continuous basis) in a 4-week cycle for a planned minimum of six cycles was performed. However, during the ongoing safety review of the first five patients, Grade 3 toxicities were observed in all five patients (four with neutropenia and one with neutropenic fever and diarrhea) and the decision was made to reduce the dose of both study

drugs. All subsequent patients (n = 55) received nab-paclitaxel (100mg/m2 i.v. on days 1, 8, and 15 every 28 days) in combination with lapatinib (1,000mg orally once daily on a continuous basis) in a 4-week cycle for a minimum of six cycles. RR Inhibitors,research,lifescience,medical was 53% with the majority of patient responses Inhibitors,research,lifescience,medical demonstrating a partial response (PR) (47%). Four (7%) patient responses demonstrated a complete response (CR), and ten (17%) demonstrated a stable disease. The progression-free survival (PFS) and time to Decitabine chemical structure progression (TTP) were 39.7 weeks (95% CI 34.1–63.9) and 41 weeks (95% CI 39.1–64.6), respectively. Lapatinib 1,000mg with nab-paclitaxel 100mg/m2 i.v. is feasible with manageable and predictable toxicity and an RR of 53% comparing favorably with other HER2-based combinations in this setting [50]. Two important points under investigation are the comparison of weekly Rebamipide nab-paclitaxel with CrEL-paclitaxel both at weekly schedules and the potential advantage of combination with bevacizumab. Finally nab-paclitaxel has shown some activity also in CrEL-paclitaxel heavily pretreated and resistant patients [28] (Table 1). Table 1 Randomized phase II and III trials with nab-paclitaxel in mBC. 4. Nab-Paclitaxel in Pancreatic Cancer Treatment Pancreatic cancer (PC) is at present a big cancer killer, with an expected survival of 6 months in advanced stage PC (aPC).