Abraxane (nab-Paclitaxel) is not typically used as monotherapy. For metastatic cancer, it is used in combination with Gemzar (Gemcitabine) as this combination through clinical trials and studies has shown to improve overall survival, progression-free survival and response rates. The IMPACT clinical trial is the one showing this data. If someone no longer was responding to Folfirinox or had DYPD and UTP1A1 deficincies involved with metabolizing 5-FU and irinotecan respectively, or lacks the specific enzyme to metabolize Gemcitabine or otherwise does not tolerate it well, then the choices are going to a second-line duel drug therapy or trying Abraxane alone. There is limited evidence in supporting its efficacy as a monotherapy and the reason why it is not done as common practice.

I would challenge the insurance decision it is widely known that Abraxane alone is not as effective. I’ve never heard of the two being denied !