{"entity":{"id":"paclitaxel","kind":"drug","name":"Paclitaxel / nab-paclitaxel","aka":[],"tldr":"A microtubule poison discovered in the Pacific yew tree, among the most used chemotherapies in breast, lung, and ovarian cancer.","summary":"Paclitaxel is a taxane that binds and stabilises microtubules, freezing the mitotic spindle so dividing cells cannot complete mitosis. Discovered in the bark of the Pacific yew, it was approved in 1992 for ovarian cancer and is now among the most used chemotherapies in breast, lung, ovarian and pancreatic cancer, at 80 mg/m2 weekly or 175 mg/m2 every 3 weeks. Weekly paclitaxel is a backbone of neoadjuvant TNBC therapy. Nab-paclitaxel binds the drug to albumin, removing the Cremophor solvent that causes hypersensitivity, so it needs no steroid premedication and is given at 100 to 125 mg/m2 on days 1, 8 and 15; it partners with immunotherapy (IMpassion130) and, in 2026, with relacorilant in ovarian cancer and TTFields in pancreatic cancer. Neuropathy and neutropenia are the main adverse events. For a newcomer: a plant-derived drug that jams the machinery of cell division.","status":"approved","asOf":"2026-09-04","wikipedia":"https://en.wikipedia.org/wiki/Paclitaxel","links":[{"label":"FDA label (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Paclitaxel"}],"tags":[],"related":["acupuncture-chemotherapy-neuropathy"],"cancers":["tnbc","breast-hr-positive","nsclc","ovarian","pancreatic","angiosarcoma","cup-favourable-subsets","metastatic-anal-cancer"],"sections":[],"technologies":["cytotoxic-chemotherapy"],"targets":[],"drugs":[],"companies":["cspc"],"institutions":[],"pathways":[],"terms":[],"trials":["nct06212752","nct06828354","nct06767527","nct07044336","nct06340568","nct06692738","nct06584032","nct04379635","nct07216703","nct07491445","nct06699212","nct05800015","nct07805954","nct06356311","nct07168200","nct06072781","nct03390686","nct05654454","nct05116462","nct06989112","nct03800134","nct06422143","nct06712316","nct07604766","nct06486441","nct06952504","nct06132958","nct03164616","nct06619236","nct05722015","nct06123884","nct04956692","nct05984277","nct06915025","nct07564141","nct06703398","nct06445062","nct05652686","nct06535607","nct06463028","nct01081951","nct05482893","nct05283226","nct04843098","nct06448754","nct04083599","nct06946797","nct05932212","nct06646055","nct06693336","nct07049055","nct07680764","nct06731907","nct05605535","nct06922591","nct05904379","nct05739981","nct06522828","nct03775486","nct06943820","nct07255404","nct07714668","nct07221474","nct05585320","nct05431270","nct07229729","nct05635708","nct06434610","nct06996782","nct06161441","nct03393884","nct05669482","nct04736173","nct07042802","nct06727565","nct04938583","nct04644068","nct07310784","nct07563738","nct06840002","nct07102381","actuate-1801","nct06449209","nct07259590","nct06843447","nct05247684","nct07322094","nct06758557","nct05824975","nct06047379","nct04931342","nct07223047","nct05742607","nct05054439","nct05814354"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"brand":"Taxol / Abraxane","modality":"Cytotoxic chemotherapy (taxane)","mechanism":"Stabilises microtubules, blocking mitosis.","approvals":[{"region":"US","year":1992,"indication":"Ovarian cancer (now broad)"}],"mechanismSteps":["Paclitaxel binds β-tubulin in microtubules","Microtubules are stabilised and cannot disassemble","Mitotic spindle dynamics fail; cells arrest in G2/M","Prolonged arrest triggers apoptosis","Rapidly dividing tumour cells (and hair follicles, marrow) are most affected"],"dosing":{"route":"IV infusion","schedule":"80 mg/m² weekly (breast, with carboplatin in TNBC) or 175 mg/m² every 3 weeks; nab-paclitaxel 100-125 mg/m² days 1, 8, 15 without premedication","modifications":"Hold for grade ≥3 neuropathy or neutropenia <1,500/µL","monitoring":"Blood counts, neuropathy, hypersensitivity (solvent-based formulation requires steroid/antihistamine premedication)","source":"https://www.fda.gov/drugs/resources-information-approved-drugs/oncology-cancer-hematologic-malignancies-approval-notifications"},"toxicity":[{"event":"Neutropenia"},{"event":"Peripheral neuropathy"},{"event":"Alopecia"},{"event":"Myalgia/arthralgia"},{"event":"Hypersensitivity reactions (Cremophor)"},{"event":"Nausea"}],"access":[{"country":"US","reimbursement":"Medicare Part B; generic paclitaxel and nab-paclitaxel available","generic":true,"source":"https://www.cms.gov/medicare/payment/part-b-drugs/asp-pricing-files","asOf":"2026-09-06"},{"country":"UK","reimbursement":"NHS standard; generic","generic":true,"asOf":"2026-09-06"}],"regulatoryEvents":[{"date":"1992-12-29","type":"approval","region":"US","note":"Refractory ovarian cancer","source":"https://www.fda.gov/drugs/resources-information-approved-drugs/oncology-cancer-hematologic-malignancies-approval-notifications"},{"date":"1994-04-13","type":"approval","region":"US","note":"Metastatic breast cancer","source":"https://www.fda.gov/drugs/resources-information-approved-drugs/oncology-cancer-hematologic-malignancies-approval-notifications"},{"date":"2005-01-07","type":"approval","region":"US","note":"nab-Paclitaxel (Abraxane) for metastatic breast cancer","source":"https://www.fda.gov/drugs/resources-information-approved-drugs/oncology-cancer-hematologic-malignancies-approval-notifications"},{"date":"2013-09-06","type":"approval","region":"US","note":"nab-Paclitaxel with gemcitabine for metastatic pancreatic cancer","source":"https://www.fda.gov/drugs/resources-information-approved-drugs/oncology-cancer-hematologic-malignancies-approval-notifications"},{"date":"2022-04","type":"approval","region":"US","note":"First nab-paclitaxel generics","source":"https://www.fda.gov/drugs/resources-information-approved-drugs/oncology-cancer-hematologic-malignancies-approval-notifications"}]},"route":"/drugs/paclitaxel/","neighbours":{"technology":[{"id":"acupuncture-chemotherapy-neuropathy","kind":"technology","name":"Acupuncture for chemotherapy-induced neuropathy","route":"/technologies/acupuncture-chemotherapy-neuropathy/"},{"id":"bimatoprost-eyelash-regrowth","kind":"technology","name":"Bimatoprost for eyelash and eyebrow regrowth","route":"/technologies/bimatoprost-eyelash-regrowth/"},{"id":"hair-topical-prevention-agents","kind":"technology","name":"Creams and lotions tried to prevent chemotherapy hair loss","route":"/technologies/hair-topical-prevention-agents/"},{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"},{"id":"dietary-supplements-treatment-interactions","kind":"technology","name":"Dietary supplements during cancer treatment: 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