Combination Therapy of Albumin-Bound Paclitaxel and Carboplatin as First Line Therapy in a Patient with Ovarian Cancer

Background. Ovarian cancer is the ninth most common cancer among women and causes more deaths than any other type of female reproductive cancer. Albumin-bound paclitaxel is known to increase intratumoral concentration of the paclitaxel by a receptor-mediated transport process across the endothelial cell wall, thereby breaching the blood/tumor interface. We present below three cases in which nab-paclitaxel based chemotherapy has been used in different settings for patients with ovarian cancer. Case Presentation. In the first case nab-paclitaxel was used along with carboplatin in adjuvant setting, in the second case, nab-paclitaxel was used along with carboplatin and bevacizumab as second line chemotherapy in a relapsed ovarian cancer case, and the third case delineates the use of nab-paclitaxel along with cisplatin as third line chemotherapy. Conclusion. In all the three scenarios, patients tolerated the chemotherapy well, as well as responding well to nab-paclitaxel based chemotherapy. The patients are currently on long-term follow-up and have been having an uneventful postchemotherapy. 1. Introduction Ovarian cancer is the ninth most common cancer in women (excluding skin cancer). It ranks fifth among the causes of cancer related deaths in women worldwide. A woman’s risk of getting invasive ovarian cancer in her lifetime is about one in 71 and the lifetime risk of dying from invasive ovarian cancer is about one in 95 [1]. However, there are large variations in the incidence of ovarian cancer in different areas across the world. In India, ovarian cancer is emerging as one of the most common malignancies affecting women according to the cancer registries [2]. It is one of the most lethal gynecologic diseases and lacks early detection through screening tests. The symptomatology is not very clear and, as a result, the disease is usually diagnosed at a later stage when growth has extended within the peritoneal cavity [3]. Carboplatin in combination with paclitaxel has been broadly accepted as first-line chemotherapy for advanced epithelial ovarian cancer [4]. Albumin-bound paclitaxel is known to increase intratumoral concentration of paclitaxel by a receptor-mediated transport process across the endothelial cell wall, thereby breaching the blood/tumor interface [5]. Teneriello et al. [6] have shown albumin-paclitaxel to be highly active as a single agent in patients with platinum-sensitive recurrent ovarian cancer. Albumin-bound paclitaxel is administered with 100？mL normal saline with no premedications as compared to the regular paclitaxel which required