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纳米白蛋白结合型紫杉醇:一种新型不含聚氧乙烯蓖麻油的紫杉醇制剂。

Nanoparticle albumin-bound paclitaxel: a novel Cremphor-EL-free formulation of paclitaxel.

作者信息

Stinchcombe Thomas E

机构信息

University of North Carolina at Chapel Hill, Multidisciplinary Thoracic Oncology Program, Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599-7305, USA.

出版信息

Nanomedicine (Lond). 2007 Aug;2(4):415-23. doi: 10.2217/17435889.2.4.415.

Abstract

Standard formulation paclitaxel requires the use of solvents, such as Cremphor-EL, which contribute to some of the toxicities commonly associated with paclitaxel-based therapy. Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) is a novel solvent-free formulation of paclitaxel. The formulation is prepared by high-pressure homogenization of paclitaxel in the presence of serum albumin into a nanoparticle colloidal suspension. The human albumin-stabilized paclitaxel particles have an average size of 130 nm. Nab-paclitaxel has several practical advantages over Cremphor-EL-paclitaxel, including a shorter infusion time (30 min) and no need for premedications for hypersensitivity reactions. The nab-paclitaxel formulation eliminates the impact of Cremphor-EL on paclitaxel pharmacokinetics and utilizes the endogenous albumin transport mechanisms to concentrate nab-paclitaxel within the tumor. A recent Phase III trial compared nab- and Cremphor-EL-paclitaxel in patients with metastatic breast cancer. Patients treated with nab-paclitaxel experienced a higher response, longer time to tumor progression and, in patients receiving second-line or greater therapy, a longer median survival. Patients treated with nab-paclitaxel had a significantly lower rate of severe neutropenia and a higher rate of sensory neuropathy. The preclinical and clinical data indicate that the nab-paclitaxel formulation has significant advantages over Cremphor-EL-paclitaxel.

摘要

标准制剂紫杉醇需要使用诸如聚氧乙烯蓖麻油等溶剂,这些溶剂会导致一些与基于紫杉醇的治疗相关的常见毒性。纳米白蛋白结合型紫杉醇(纳米紫杉醇)是一种新型的无溶剂紫杉醇制剂。该制剂是通过在血清白蛋白存在下将紫杉醇进行高压均质化制备成纳米颗粒胶体悬浮液。人白蛋白稳定的紫杉醇颗粒平均大小为130纳米。与聚氧乙烯蓖麻油紫杉醇相比,纳米紫杉醇有几个实际优势,包括输注时间更短(30分钟)且无需针对过敏反应进行预处理。纳米紫杉醇制剂消除了聚氧乙烯蓖麻油对紫杉醇药代动力学的影响,并利用内源性白蛋白转运机制使纳米紫杉醇在肿瘤内聚集。最近的一项III期试验比较了纳米紫杉醇和聚氧乙烯蓖麻油紫杉醇在转移性乳腺癌患者中的疗效。接受纳米紫杉醇治疗的患者有更高的缓解率、更长的肿瘤进展时间,并且在接受二线或更高线治疗的患者中,有更长的中位生存期。接受纳米紫杉醇治疗的患者严重中性粒细胞减少的发生率显著更低,而感觉神经病变的发生率更高。临床前和临床数据表明,纳米紫杉醇制剂比聚氧乙烯蓖麻油紫杉醇具有显著优势。

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