Waleed H. Almalki
Breast cancer remains one of the leading causes of cancer-related mortality in women, accounting for approximately 23.8% of all female cancer cases. Despite the availability of chemotherapeutic agents, treatment efficacy is often hindered by drug resistance, dose-dependent toxicity, and poor tumor targeting. Paclitaxel (PTX) is widely used in breast cancer therapy due to its ability to promote tubulin polymerization, inhibit cell division, and induce apoptosis. However, its clinical potential is restricted by poor solubility, systemic toxicity, hypersensitivity, and multidrug resistance. Co-delivery approaches, combining PTX with other therapeutic agents such as chemotherapeutics, natural compounds, or nucleic acids within a single nanocarrier, offer a promising strategy to overcome these limitations. The presented review provides in depth analysis of PTX-based co-delivery systems in breast cancer therapy, focusing on various nanocarrier platforms including liposomes, micelles, polymeric nanoparticles, and lipid-polymer hybrids. It discusses their design principles, synergistic mechanisms, and therapeutic advantages, alongside insights from ongoing clinical trials and regulatory developments. Furthermore, the review outlines major translational challenges and highlights future directions involving personalized medicine, advanced nanomaterials, and scalable production to enhance the clinical translation of PTX-based co-delivery nanotherapeutics for effective breast cancer management.