Paclitaxel

Taxol structure

Paclitaxel

Paclitaxel is an antineoplastic agent which acts by inhibitor of cellular mitosis and which currently plays a central role in the therapy of ovarian, breast, and lung cancer. 

Liver safety of Paclitaxel

Therapy with paclitaxel has been associated with a low rate of serum enzyme elevations, but has not been clearly linked to cases of clinically apparent acute liver injury.

Mechanism of action of Paclitaxel

Paclitaxel (pak" li tax' el) is a complex diterpenoid molecule that contains a central 8-member taxane ring.  Paclitaxel was initially isolated from the bark of the Western Yew tree (Taxus breviflora) and found to have antitumor activity in high throughput assays.  It is a potent antineoplastic agent and its mechanism of action appears to be mediated by its binding to microtubulin, which is important in the mitototic phase of cell division.  The binding of paclitaxel prevents the disassembly of the cytoskeletal microtubules, preventing cell division and leading to cell death. 

FDA approval information for Paclitaxel

Paclitaxel was approved for use in the United States in 1992 and it remains an important agent in the therapy of several cancers.  Paclitaxel is considered a first line treatment for advanced ovarian carcinoma and is also used in breast cancer and advanced non-small cell lung cancer and AIDS-related Kaposi's sarcoma.

Dosage and administration for Paclitaxel

Paclitaxel is available in solution for injection (6 mg/mL) generically and under the brand names Taxol and Onxol.  Paclitaxel is also available as protein bound particles in a lyphophilized powder for injection under the brand name Abraxane.  Paclitaxel is administered intravenously, typically as 3 to 24 hour infusions every three weeks in cycles in combination with other antineoplastic agents.  The dose varies by indication and body weight and is reduced in persons with preexisting liver disease. 

Side effects of Paclitaxel

Side effects are common and include diarrhea, nausea, vomiting, mucositis, fatigue, mylagias, skin rash, alopecia, phlebitis, bone marrow suppression, fluid retention, cardiomyopathy, peripheral neuropathy and hypersensitivity reactions.  Alphabetic list of antineoplastic agents - 0-9 - A1 - A2 - A3 - A4 - A5 -A6 - B - C - D - E - F - G - H - I - JK - L - M - NO - PQ - R - S - T - UVW - XYZ