Lluch Ana, Alvarez Isabel, Muñoz Montserrat, Seguí Miguel Ángel, Tusquets Ignasi, García-Estévez Laura
Hospital Clínico Universitario de Valencia, Valencia, Spain.
Hospital Universitario de Donostia, San Sebastian, Spain.
Crit Rev Oncol Hematol. 2014 Jan;89(1):62-72. doi: 10.1016/j.critrevonc.2013.08.001. Epub 2013 Aug 21.
In spite of recent advances in the treatment of metastatic breast cancer, this disease remains essentially incurable. Anthracyclines and taxanes have been widely demonstrated to be the most active cytotoxic drugs for the treatment of breast cancer. Paclitaxel and docetaxel are both hydrophobic drugs that need to be administered with detergent-like substances as solvents. In contrast, nanoparticle albumin-bound (nab) paclitaxel uses the natural characteristics of albumin to reversibly bind paclitaxel, transport it across endothelial cells and concentrate the active ingredient within the tumor. Several trials have demonstrated that nab-paclitaxel results in superior efficacy, with more complete responses, prolonged time to recurrence and survival, than paclitaxel and docetaxel in MBC. As second-line treatment, the novel formulation has almost doubled overall response rate, increased time to progression and overall survival in comparison with paclitaxel. Due to these results, to date nab-paclitaxel stands out as a promising treatment of metastatic breast cancer.
尽管转移性乳腺癌的治疗最近取得了进展,但这种疾病基本上仍然无法治愈。蒽环类药物和紫杉烷类药物已被广泛证明是治疗乳腺癌最有效的细胞毒性药物。紫杉醇和多西他赛都是疏水性药物,需要与类似洗涤剂的物质作为溶剂一起给药。相比之下,纳米白蛋白结合型(nab)紫杉醇利用白蛋白的天然特性与紫杉醇可逆结合,将其运输穿过内皮细胞并将活性成分集中在肿瘤内。多项试验表明,在转移性乳腺癌中,nab-紫杉醇比紫杉醇和多西他赛具有更高的疗效,有更完全的反应、更长的复发时间和生存期。作为二线治疗,与紫杉醇相比,这种新制剂的总体缓解率几乎翻了一番,疾病进展时间和总生存期都有所增加。由于这些结果,迄今为止,nab-紫杉醇是转移性乳腺癌一种很有前景的治疗方法。