轉移性乳癌、非小細胞肺癌、胰腺癌Breast cancer, metastatic: Treatment of breast cancer after failure of combination chemotherapy for metastatic disease or relapse within 6 months of adjuvant chemotherapy
Non-small cell lung cancer, locally advanced or metastatic: First-line treatment of locally advanced or metastatic NSCLC (in combination with carboplatin) in patients who are not candidates for curative surgery or radiation therapy
Pancreatic adenocarcinoma, metastatic: First-line treatment of metastatic adenocarcinoma of the pancreas (in combination with gemcitabine)

Antineoplastic Agent, Antimicrotubular; Taxane Derivative
Paclitaxel (protein bound) is an albumin-bound paclitaxel nanoparticle formulation; paclitaxel promotes microtubule assembly by enhancing the action of tubulin dimers, stabilizing existing microtubules, and inhibiting their disassembly, interfering with the late G2 mitotic phase, and inhibiting cell replication.

Distribution:
1. Vd: 1741 L (extensive extravascular distribution and/or tissue binding)
2. Protein binding: 94%
Metabolism:
1. Hepatic primarily via CYP2C8 to 6-alpha-hydroxypaclitaxel; also to minor metabolites via CYP3A4
2. Half-life elimination: Terminal: 13 to 27 hours
Excretion:
1. Feces (~20%); urine (4% as unchanged drug, <1% as metabolites)
2. Clearance: 13 to 30 L/hour/m²

1. Baseline neutrophil count of <1,500/mm³
2. History of severe hypersensitivity reaction to paclitaxel (protein bound) or any component of the formulation

Based on the mechanism of action and on findings in animal reproduction studies, paclitaxel (protein bound) may cause fetal harm if administered during pregnancy.

Due to the potential for serious adverse reactions in the breastfed infant, the manufacturer recommends patients not breastfeed during therapy and for 2 weeks following the last paclitaxel (protein bound) dose.

ECG abnormality, peripheral edema, skin rash, hypokalemia, diarrhea, nausea, urinary tract infection, anemia, bone marrow depression, neutropenia, thrombocytopenia, increased serum AST or ALT, depression, fatigue, headache, myalgia, visual disturbance, increased serum creatinine, dyspnea, fever

Breast cancer, metastatic:
IV: 260 mg/m2 every 3 weeks
NSCLC, locally advanced or metastatic:
IV: 100 mg/m2 on days 1, 8, and 15 of each 21-day cycle (in combination with carboplatin)
Pancreatic adenocarcinoma, metastatic:
IV: 125 mg/m2 on days 1, 8, and 15 of a 28-day cycle (in combination with gemcitabine)

1. CrCl ≥30 mL/minute: No dosage adjustment necessary
2. CrCl <30 mL/minute, ESRD: There are no dosage adjustments provided in the manufacturer's labeling (insufficient data)