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A microtubule poison discovered in the Pacific yew tree, among the most used chemotherapies in breast, lung, and ovarian cancer.
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.
Ball-and-stick model from PubChem 2D record (no 3D conformer available). PubChem record
Stabilises microtubules, blocking mitosis.
1.Paclitaxel binds β-tubulin in microtubules
Source: www.fda.gov/drugs/resources-information-approved-drugs/oncology-cancer-hematologic-malignancies-approval-notifications. Doses are for orientation; the current label governs.
Given by infusion or injection in a clinic or hospital outpatient department, so it is a Part B drug: Medicare pays 80% after the Part B deductible and the patient owes 20% coinsurance, uncapped in Original Medicare unless a Medigap policy applies. HCPCS J9267 for paclitaxel (generic). Nab-paclitaxel (Abraxane) is also Part B; generics launched in 2022.
Multi-source generic; covered under the medical benefit without prior authorisation in most plans, as part of standard regimens. Some plans apply prior authorisation to nab-paclitaxel because of its higher price.
Sources: Medicare.gov: Chemotherapy · Medicare.gov: Prescription drugs (outpatient, Part B). Not medical or financial advice; verify with your plan.
Sources: NICE TA476 · SMC advice: paclitaxel / nab-paclitaxel. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
Refractory ovarian cancer source
Metastatic breast cancer source
nab-Paclitaxel (Abraxane) for metastatic breast cancer source
nab-Paclitaxel with gemcitabine for metastatic pancreatic cancer source
First nab-paclitaxel generics source
| Region | Year | Indication |
|---|---|---|
| US | 1992 | Ovarian cancer (now broad) |
| Adverse event |
|---|
| Neutropenia |
| Peripheral neuropathy |
| Alopecia |
| Myalgia/arthralgia |
| Hypersensitivity reactions (Cremophor) |
| Nausea |
Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
Read for the class this product belongs to (taxanes) unless the answer names the product. Population figures from the cohorts named, not a prediction for one person. Blank where no source gives a recovery figure.
| Country | Reimbursement | List price | Assistance |
|---|---|---|---|
| United Statesgeneric | Medicare Part B; generic paclitaxel and nab-paclitaxel available | not disclosed | - |
| United Kingdomgeneric | NHS standard; generic | not disclosed | - |
List prices are manufacturer or Medicare figures where publicly disclosed; net prices after rebates are usually lower. Reimbursement changes; check the payer.
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The latest in a line of negative targeted-therapy trials in triple-negative disease (EGFR, VEGF, iniparib, now AKT): a modest delay in progression that did not translate into survival, in the same year that an antibody-drug conjugate did. It is why the roadmap treats pathway-targeted small molecules as the road not taken.
Retifanlimab with carboplatin-paclitaxel is the new first-line standard for advanced anal squamous cell carcinoma; approved in the United States in May 2025.
Comprehensive genomic profiling at diagnosis is now justified for unfavourable cancer of unknown primary, with a switch to a matched drug after induction chemotherapy when an actionable target is found.
The strongest signal that neoadjuvant immunotherapy makes stage III lung cancer operable as well as more often curable. Twenty-four percentage points more patients reaching surgery is a result that only a neoadjuvant design can produce.
Women with newly diagnosed advanced or recurrent endometrial cancer should receive a PD-1 antibody (dostarlimab or pembrolizumab) with their chemotherapy, and mismatch repair testing is now essential because women with dMMR tumours gain a very large and durable benefit. The gain in mismatch-repair-proficient tumours is real but smaller, and molecular classification (POLE, p53, MMR) is increasingly used to decide who benefits most.
Patients with operable stage II-III lung cancer without EGFR or ALK alterations should have chemo-immunotherapy discussed before surgery rather than only afterwards. Three pre-operative cycles do not compromise the operation and improve cure rates. Whether to continue immunotherapy after surgery, as the perioperative trials do, and whether patients with pCR need any further treatment, remain open questions.
For stage II-III triple-negative breast cancer, chemotherapy plus pembrolizumab before surgery and pembrolizumab alone afterwards is now the standard approach worldwide, and the survival gain is real, not just a surrogate. It does not apply to stage I disease or to hormone-receptor-positive or HER2-positive cancers. The price is a year of immunotherapy with a meaningful chance of a permanent endocrine side effect such as hypothyroidism or adrenal insufficiency.
The third trial to show carboplatin's benefit persists beyond pathological complete response and the trial that closed the neoadjuvant PARP inhibitor route in unselected triple-negative disease; PARP inhibition survives only in germline BRCA carriers.
Query for this drug: (TITLE:"Paclitaxel / nab-paclitaxel" OR ABSTRACT:"Paclitaxel / nab-paclitaxel" OR TITLE:"Taxol" OR ABSTRACT:"Taxol" OR TITLE:"Abraxane" OR ABSTRACT:"Abraxane") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Paclitaxel / nab-paclitaxel, not a curated reading list.
Shares CATALINA-4: A Study to Investigate the Safety and Efficacy of TORL-1-23 With Chemotherapy Given Before Initial Surgery in Women With Advanced Stage Ov, Study of IMNN-001 (Also Known as GEN-1) With NACT for Treatment of Ovarian Cancer (OVATION 2), A Study to Evaluate SSGJ-707 in Advanced Gynecologic Cancer Patients, A Study to Evaluate the Safety and Efficacy of HB0025 Injection in Patients With Advanced Solid Tumor.
Shares Intensified therapies improve survival and identification of novel prognostic factors for placental-site and epithelioid trophoblastic tumours, Neoadjuvant paclitaxel, ifosfamide and cisplatin (TIP) for penile cancer with bulky lymph node metastases, Personalized Neck Radiation Therapy Directed by Sentinel Lymph Node Biopsy for the Treatment of Oral Cavity Squamous Cell Carcinoma, PRECEDENT Trial, A Phase II Trial of LM103 in Advanced Melanoma.
Shares A Study to Evaluate the Safety and Efficacy of HB0025 Injection in Patients With Advanced Solid Tumor, Volrustomig Priming Regimens Exploratory Phase II Platform Study, A Global Study of Volrustomig (MEDI5752) Plus Chemotherapy Versus Pembrolizumab Plus Chemotherapy for Participants With Metastatic Non-small Cell Lung, A Study To Assess the Safety, Tolerability, and Efficacy of Imzokitug in Combination With Pumitamig and Platinum-Doublet Chemotherapy (PDCT) Versus Pu.
Shares A Randomized Controlled Trial of Neoadjuvant Weekly Paclitaxel Versus Weekly Paclitaxel Plus Weekly Carboplatin In Women With Large Operable or Locally Advanced, Carboplatin Intensified Chemotherapy for TRIple NEgative Breast Cancer(CITRINE), Cyclin dEpendent Kinase in tRiple nEGatIVe brEast canceR - a "Window of Opportunity" Study, Oregovomab Plus Chemotherapy in Neo-adjuvant Setting in Newly Diagnosed Patients With Advanced Epithelial Ovarian Cancer.
Shares A Clinical Study of SI-B001 in Combination With Paclitaxel/Docetaxel in the Treatment of Recurrent and Metastatic HNSCC, Chemotherapy With or Without Trastuzumab After Surgery in Treating Women With Invasive Breast Cancer, Non-Inferiority Study on MRNA-lncRNA Model in Low-Risk Triple-Negative Breast Cancer Patients, Creams and lotions tried to prevent chemotherapy hair loss.
Shares A Study of Ixabepilone as Second-line Therapy for Locally Advanced, Recurrent, or Metastatic Endometrial Cancer, Chemotherapy With or Without Trastuzumab After Surgery in Treating Women With Invasive Breast Cancer, Puxitatug Samrotecan (AZD8205) Monotherapy vs Chemotherapy in B7-H4-selected Endometrial Cancer (Bluestar-Endometrial01), Sacituzumab Tirumotecan (MK-2870) in Post Platinum and Post Immunotherapy Endometrial Cancer (MK-2870-005).
Shares A Phase 1/2a Study of IMM-1-104 in Participants With Advanced or Metastatic Solid Tumors, Pembrolizumab + Paclitaxel +/- Bevacizumab for Triple-negative Breast Cancer, A Global Phase III Study of Rilvegostomig or Pembrolizumab Plus Chemotherapy for First-Line Treatment of Locally Advanced or Metastatic Squamous Non-s, A Global Study of Volrustomig (MEDI5752) Plus Chemotherapy Versus Pembrolizumab Plus Chemotherapy for Participants With Metastatic Non-small Cell Lung.
Shares Study of Avutometinib (VS-6766) +Defactinib With Gemcitabine and Nab-paclitaxel in Patients With Pancreatic Cancer, Study to Evaluate the Safety and Efficacy of Treatment With NLM-001 and Standard Chemotherapy Plus Zalifrelimab in Patients With Advanced Pancreatic C, A Clinical Trial Testing the Safety of Pumitamig (an Investigational Drug) and How Well it Works When Combined With Chemotherapy for People Who Have N, A Clinical Trial to Evaluate EDV Nanocell Therapy With Gemcitabine and Nab-paclitaxel in Pancreatic Cancer.