Paclitaxel (Taxol)

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General information

Class/mechanism: Taxane, promotes assembly of microtubules, stablizes microtubules, preventing depolymerization. Paclitaxel interferes with the normal dynamic reorganization of microtubules that is necessary for regular interphase/mitosis processes. It also leads to creation of abnormal bundles of microtubules. Paclitaxel is highly lipophilic/insoluble in water and needs to be dissolved in Cremophor EL (polyoxyethylated castor oil), which may cause hypersensitivity infusion reactions.[1][2]
Route: IV
Extravasation: irritant (usually), vesicant (rare)

For conciseness and simplicity, currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.[1]

Diseases for which it is established (work in progress)

Diseases for which it is used

Patient drug information

History of changes in FDA indication

  • 12/29/1992: Initial FDA approval for treatment of patients with metastatic carcinoma of the ovary after failure of first-line or subsequent chemotherapy. (Based on Eisenhauer et al. 1994)
  • 4/9/1998 (oldest label available at [email protected]): Indicated for first-line and subsequent therapy for the treatment of advanced carcinoma of the ovary. As first-line therapy, Taxol is indicated in combination with cisplatin. (Based on GOG 111 & OV10)
  • 4/9/1998 (oldest label available at [email protected]): Indicated for the treatment of breast cancer after failure of combination therapy for metastatic disease or relapsed within 6 months of adjuvant chemotherapy. Prior therapy should have included an anthracycline unless clinically contraindicated. (Based on Nabholtz et al. 1996)
  • 4/9/1998 (oldest label available at [email protected]): Indicated for the second-line treatment of AIDS-related Kaposi's sarcoma. (Based on CA139-174 & CA139-281)
  • 6/30/1998: New indication added: in combination with cisplatin, is indicated for the first-line treatment of non-small cell lung cancer in patients who are not candidates for potentially curative surgery and/or radiation therapy. (Based on ECOG E5592)
  • 10/25/1999: New indication for the adjuvant treatment of node-positive breast cancer administered sequentially to standard doxorubicin-containing combination chemotherapy. (Based on INT 0148/CALGB 9344)

Also known as

  • Brand names:
Abitaxel Altaxel Anzatax Anzatec Apealea Asotax Betaxel Bristaxol
Britaxol Clitaxel Cytax Daburex Dalys Drifen Ebetaxel Formoxol
Genexol Genetaxyl Gros Ifaxol Intaxel Magytax Medixel Mitotax
Neotacs Neotaxan Neotaxl Ofoxel Oncotaxel Onxol Paclitax Paclitaxin
Pacliteva Pacxel Padexol Paklitaxfil Panataxel Parexel Paxene Paxenor
Paxus Pazenir Petaxel Phyxol Poltaxel Praxel Ribotax Sindaxel
Taclipaxol Tarvexol Taxocris Taxodiol Taxol Taxomedac Taycovit Unitaxel