Background and purpose: Nab-paclitaxel (Abraxane) is an albumin-bound form of paclitaxel that utilizes the natural properties of albumin to improve paclitaxel delivery to the tumor. It has recently been approved for treatment of breast cancer after failure of combination chemotherapy for metastatic disease or relapse within short time after adjuvant chemotherapy. The purpose of this study was to evaluate the efficacy and safety of albumin-bound paclitaxel in patients with aggressive and refractory metastatic breast cancer (MBC). Methods: A total of 58 patients with MBC were enrolled into this study from Jul. 2009 to Jan. 2014. All patients received albumin-bound paclitaxelbased chemotherapy. The adverse reactions were evaluated every cycle

and the short-term response was evaluated every two cycles. The patients were followed-up

and the survival was analyzed. Results: 58 patients with refractory MBC were evaluable for response

67.2% of patients received multiple line (≥3 lines) chemotherapy

32.8% of patients with first and second line of chemotherapy were involved metastasis within one year after adjuvant chemotherapy

84.5% of patients with visceral metastasis and 93.1% with prior taxane treatment. The objective response rate (ORR) was 13.8%

and disease control rate (DCR) was 60.3%

the median progression free survival (PFS) was 4.0 months

and the overall survival (OS) was 10.1 months. For 23 patients with triple negative breast cancer

ORR was 13.0% and DCR was 56.5%

the median PFS was 4.1 months

and OS was 6.6 months. The main toxicity was myelosuppression (grades 3 and 4 neutropenia

anemia and thombocytopenia were seen in 34.5%

12.1% and 6.9% of patients

respectively)

gastrointestinal reactions

sensory neuropathy

myodynia/arthragia

fatigue

alopecia and so on. Conclusion: The albumin-bound paclitaxel-based chemotherapy can be used in aggressive and refractory MBC. It also showed antitumor activity in taxanes-resistance patients and triple negative patients with good safety and tolerance.