Abraxane in the treatment of ovarian cancer: the absence of hypersensitivity reactions.

Background: Paclitaxel is one of the most active agents in the treatment of ovarian carcinoma. However, paclitaxel is solubilized in cremophor, a polyoxyethylated castor oil. Cremophor is allegedly responsible for many paclitaxel-associated hypersensitivity reactions (HSR). Novel agents such as abraxane are solvent free and currently being evaluated to potentially avoid certain patient side effects.

Case: We present a case involving a 60-year-old ovarian cancer patient with a significant history of chemotherapy induced HSR. She underwent optimal cytoreductive surgery and began adjuvant chemotherapy in 2000 until she suffered a severe HSR to paclitaxel. In 2002, she was diagnosed with recurrent disease and underwent subsequent treatment with carboplatin, cisplatin, and doxorubicin, all of which resulted in severe HSR. The patient began abraxane therapy in 2005 and has shown no signs of HSR.

Conclusion: Abraxane is a solvent free taxane, which can be administered without the pre-medications routinely used to prevent HSR. Abraxane may offer paclitaxel HSR patients the benefit of continued taxane treatment. Although the clinical activity of abraxane has not been extensively investigated in ovarian carcinoma, the distinct activity of paclitaxel and good results with recurrent metastatic breast cancer patients suggest additional evaluation with this drug is important.