Targeted Nanomedicine in Oncology: Novel Mechanisms of Abraxane in Overcoming Resistance in Breast Cancer

Abstract

Breast cancer remains a major global health problem, and treatment resistance is a major barrier to successful therapy. Conventional paclitaxel has limitations such as poor solubility, solvent-related toxicity, and drug efflux–mediated resistance. Nanomedicine offers solutions to these problems, and Abraxane is one such clinically proven nano formulation that improves drug delivery and therapeutic outcomes. This review examines how Abraxane helps overcome paclitaxel resistance, summarizes key preclinical and clinical findings, and discusses future directions for nanotechnology-based treatments. A systematic search was conducted using PubMed, Google Scholar, and clinical trial databases to evaluate mechanisms related to nanocarrier function, tumour microenvironment changes, efflux avoidance, and clinical performance. Abraxane shows higher tumour uptake through gp60-mediated transcytosis, SPARC-based stromal binding, and enhanced vascular permeability. These mechanisms help the drug bypass P-glycoprotein efflux, increase intracellular paclitaxel levels, and favourably modify the tumour microenvironment. Clinical studies, including CALGB 40502 and IMpassion130, report better responses, improved progressionfree survival, and reduced toxicity compared with solvent-based paclitaxel. Additionally, Abraxane enhances immune activity and improves response to checkpoint inhibitors. Abraxane demonstrates how nanomedicine can overcome drug resistance and improve outcomes in breast cancer. Continued development of multifunctional and biomarkerguided nanocarriers may further support personalized cancer therapy in the future.