Abraxane for the treatment of gynecologic cancer patients with severe hypersensitivity reactions to paclitaxel

Background: Paclitaxel is used in the treatment of most gynecologic malignancies. It is solubilized in Cremophor EL, a polyoxyethylated castor oil agent responsible for the high rate of paclitaxel-associated hypersensitivity reactions. Abraxane, a newer, CremophorYfree form of albumin bound paclitaxel has demonstrated an activity and an improved toxicity profile in breast and lung cancers. Case Reports: Five patients with gynecologic cancers (2 ovarian, 2 endometrial, and 1 cervical malignancy) received Abraxane after having a hypersensitivity reaction to paclitaxel. All five patients tolerated Abraxane well, experiencing no reactions or major side effects to the drug. Discussion: Abraxane is well tolerated in women with gynecologic cancer who have experienced a paclitaxel-associated hypersensitivity reaction. Further studies are ongoing to determine the clinical activity of Abraxane in the treatment of these malignancies.