Longer first line chemotherapy duration has recently been associated with a modest, but
significant improvement in overall survival and a clinically meaningful and statistically
significant improvement in progression-free survival, in metastatic breast cancer patients.
Prolonging chemotherapy until disease progression, however, must be weighed against the
detrimental effects of continuous chemotherapy delivery. The SNAP trial seeks to improve the
tolerability of prolonged chemotherapy administration strategy by studying alternative
treatment schedules, while preserving and possibly improving treatment efficacy in this
The availability of a new nanoparticle albumin-bound taxane, nab-Paclitaxel (Abraxane®),
represents an opportunity to test this hypothesis. Nab-Paclitaxel has been developed in an
attempt to reduce the toxicity associated with standard taxane administration (caused by the
use of chemical solvents) while increasing antitumor efficacy.
The SNAP randomized phase II trial evaluates three schedules of nab-Paclitaxel as prolonged
chemotherapy administration strategy. Each of three arms will be compared to a historical
reference of seven-month median progression-free survival (PFS) based on the most recent
trial with docetaxel as control arm to determine whether any of the three arms are worthy of