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Abraxane

Clinical Pharmacology
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Clinical Pharmacology

Randomized Comparative Study- This multicenter trial was conducted in 460 patients with metastatic breast cancer. Patients were randomized to receive ABRAXANE at a dose of 260 mg/m2 given as a 30-minute infusion, or paclitaxel injection at 175 mg/m2 given as a 3-hour infusion. Sixty-four percent of patients had impaired performance status (ECOG 1 or 2) at study entry; 79% had visceral metastases; and 76% had > 3 sites of metastases. Fourteen percent of the patients had not received prior chemotherapy; 27% had received chemotherapy in the adjuvant setting, 40% in the metastatic setting and 19% in both metastatic and adjuvant settings. Fifty- nine percent received study drug as second or greater than second-line therapy. Seventy-seven percent of the patients had been previously exposed to anthracyclines.

In this trial, patients in the ABRAXANE® treatment arm had a statistically significantly higher reconciled target lesion response rate (the trial primary endpoint) of 21.5% (95% CI: 16.2% to 26.7%), compared to 11.1% (95% CI: 6.9% to 15.1%) for patients in the paclitaxel injection treatment arm. See Table 1. There was no statistically significant difference in overall survival between the two study arms.

Table 1: Efficacy Results from Randomized Trial

  ABRAXANE
260 mg/m2
Paclitaxel Injection
175 mg/m2
Reconciled Target Lesion Response Rate (primary endpoint)a
All randomized patients Response Rate
[95% CI]
50/233 (21.5%)
[16.19% – 26.73%]
25/227 (11.1%)
[6.94% – 15.09%]
  P-value b 0.003
Patients who had failed combination chemotherapy or relapsed within 6 months of adjuvant chemotherapyc Response Rate [95% CI] 20/129 (15.5%)
[9.26% – 21.75%]
12/143 (8.4%)
[3.85% – 12.94%]
a Reconciled Target Lesion Response Rate (TLRR) was the prospectively defined protocol specificendpoint, based on independent radiologic assessment of tumor responses reconciled withinvestigator responses (which also included clinical information) for the first 6 cycles of therapy.The reconciled TLRR was lower than the investigator Reported Response Rates, which are based onall cycles of therapy.
b From Cochran-Mantel-Haenszel test stratified by 1st line vs. > 1st line therapy.
c Prior therapy included an anthracycline unless clinically contraindicated

Brand Name: Abraxane
Generic Name: Albumin-bound Paclitaxel
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