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Drug information (i. Anti-infectives, ii. cytostatics, iii. others)
Experience with the safety of albumin-bound paclitaxel in metastatic pancreatic adenocarcinoma
  1. V. Gonzalez Paniagua,
  2. S. Alonso Castellanos,
  3. M.A. Pedrosa Naudín,
  4. E. Briones Cuesta,
  5. A. Lopez Insua,
  6. B. Oca Luis,
  7. M. Espeja Martinez,
  8. M.P. Espinosa Gomez,
  9. M.A. Machín Morón,
  10. M. Güemes García
  1. 1Hospital General Yagüe, Farmacia, Burgos, Spain

Abstract

Background Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) is a protein-bound derivative of paclitaxel with improved solubility over conventional paclitaxel. This allows a shorter infusion time, reduces the risk of hypersensitivity reactions and eliminates the need for premedication with dexamethasone, dexchlorpheniramine and ranitidine.

Purpose The aim was to determine the off-label use and evaluate the toxicity of, and tolerance towards, nab-paclitaxel in patients with metastatic pancreatic adenocarcinoma.

Materials and methods Retrospective observational study of two patients with metastatic pancreatic adenocarcinoma treated with nab-paclitaxel. Data were collected from the cytostatics software Oncofarm, patient histories and record of tests performed with Omega3MIL software.

Results Patient 1: A seventy-six year-old woman, diagnosed with pancreatic adenocarcinoma cT3cN0M1 (hepatic cells) in February 2011, started first-line treatment with gemcitabine-oxaliplatin x 5 cycles. In April 2011, biochemical and hepatic progression, second-line treatment with capecitabine-erlotinib x 3 cycles. In July 2011, biochemical and clinical progression, third-line treatment with nab-paclitaxel 100 mg/m2 and gemcitabine 800 mg/m2 days 1, 8 and 15 every 4 weeks. Received 3 cycles in total until progression of the disease in October 2011. The patient developed second-degree lymphopenia and anaemia. Patient 2: A fifty-eight year-old man, diagnosed with pancreatic adenocarcinoma pT3pN1(7/19)M1 (lung, retroperitoneal ganglion and hepatic cells). Head-pancreaticoduodenectomy was performed. In December 2009, first-line treatment with gemcitabine-oxaliplatin x12 cycles followed by gemcitabine monotherapy x11 cycles. In December 2010, progression in lungs and liver. Started second-line treatment with capecitabine-erlotinib x5 cycles. In May 2011, pulmonary and hepatic progression. Started third-line treatment with nab-paclitaxel 100 mg/m2 days 1, 8 and 15 every 4 weeks. The patient had received 5 cycles and was continuing treatment at the time of writing. First-degree anaemia was observed.

Conclusions The patients tolerated the treatment well. They did not develop any severe adverse reactions associated with nab-paclitaxel. Peripheral neuropathy, neutropenia and hypersensitivity reactions were not observed. No doses of the drug needed to be omitted or postponed.

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