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Taxane — microtubule stabilizer

nab-Paclitaxel

Abraxanealbumin-bound paclitaxel

How it works

Binds to β-tubulin; stabilizes microtubules and inhibits mitosis. Albumin-bound formulation reduces hypersensitivity; nanoparticle delivers drug to tumor stroma.

Cumulative neuropathy is the main toxicity. Early flagging of tingling/numbness is critical to preserve function.

Dosing

Typical doses

  • 125 mg/m² IV

Schedule

  • D1/D8/D15 of 28-day cycle
    cycle_linked

Side Effects

  • Peripheral neuropathy (cumulative, dose-dependent) — paresthesia, numbness
  • Myalgia, arthralgia (joint/muscle pain)
  • Fatigue
  • Alopecia (hair loss)
  • Mild nausea, vomiting (less than gemcitabine alone)
  • Severe peripheral neuropathy — may be irreversible, dose-limiting
  • Myelosuppression (less common than gemcitabine)

Monitoring

  • Neuropathy grade at each visit (CTCAE v5). Dose hold or reduce if Grade 2+.
  • FBC before each dose