Paclitaxel

Paclitaxel Information

    Paclitaxel

  • Other names: Abraxane, Anzatax, Asotax, Bristaxol, Onxol, Praxel, Taxol, Taxol Konzentrat

  • Manufactured by: Bristol-Myers Squibb
  • FDA-approved: Yes
  • Used or tested in: Bladder cancer, breast cancer, cervical cancer, esophageal cancer, head and neck cancers, cancer of the lining of the uterus, mesothelioma

Paclitaxel is a chemotherapeutic drug being tested in mesothelioma patients. Researchers have proved it to be safe and effective against some cancers, and the Food and Drug Administration (FDA) approved the drug for use against breast cancer, non-small cell lung cancer and ovarian cancer. Paclitaxel may be referred to as Taxol, its brand-name equivalent manufactured by Bristol-Myers Squibb.

Despite the drug’s success in treating some cancers, past clinical trials in mesothelioma patients have had less than ideal outcomes, with most patients experiencing no benefits. Doctors believe this chemotherapy agent, like cisplatin and carboplatin, will work best when combined with other treatments such as surgery, radiation therapy and other chemotherapy drugs. Because of this, more recent mesothelioma trials have focused on this combination treatment, called multimodal therapy, and hope to see positive results in the future.

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Discovery and History

This promising drug dates back to the late 1960s, when it was discovered in the bark of the Pacific yew tree. Its potential as an anti-cancer agent was immediately recognized, but its natural scarcity made it difficult to market. More than 20 years later, researchers were finally able to synthetically produce it. That same year, Bristol-Myers Squibb began marketing Taxol.

How and When is it Used?

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A doctor or nurse may inject paclitaxel into a vein or give it via a three-hour intravenous drip. Both treatments are administered once every three weeks.

For mesothelioma, this drug may be used in conjunction with other chemotherapy drugs such as cisplatin or carboplatin. In these cases, the patient usually receives both chemotherapy drugs intravenously on the same day.

Paclitaxel is known as an antimicrotubule agent. Once inside the body, it binds to proteins in microtubules, which are necessary for cell division, and blocks their functions.

This forces the cells to stop dividing, which eventually kills them. Since mesothelioma cancer cells rapidly divide and spread, their microtubules are a logical target.

What are the Side Effects?

Like any chemotherapy agent, paclitaxel may damage healthy cells in addition to cancer cells. This can result in side effects such as nausea, hair loss, mouth sores and fatigue. Rare, but dangerous side effects include numbness in the extremities, excessive fatigue, chest pain or slowed heartbeat.

Study Results in Mesothelioma Patients

Based on its success in treating patients with other types of cancer, doctors believe paclitaxel will eventually have a practical use in mesothelioma patients as well. However, its efficacy in treating mesothelioma remains questionable. Early studies in the late 1990s showed no improvements in life span.

The trials in the '90s tested the drug as a single agent, meaning no other cancer treatments were given during the clinical trials. These tests showed no improvements. A 1996 study reported a median survival time of nine months, and a similar 1999 study reported a median survival of five months.

Despite less-than-hopeful clinical trial results in the past, doctors are still optimistic about the future role of paclitaxel in the treatment of mesothelioma. They continue to study the drug to find new ways of using it to treat mesothelioma patients. For example, a recent Phase II study, for which results are not yet available, focused on administering the drug in combination with surgery and heated chemotherapy.

Additional Resources

  1. Bristol-Myers Squibb (2011). Products. Retrieved from http://www.bms.com/products/Pages/home.aspx
  2. Chemocare (2011). Chemotherapy Drugs: Paclitaxel. Retrieved from http://www.chemocare.com/bio/paclitaxel.asp
  3. Genentech (2011). Product Information: Avastin. Retrieved from http://www.gene.com/gene/products/information/oncology/avastin/
  4. Hughes, M.S. (2011). Treatment of Peritoneal Cancer with Surgery, Perfused Heated Cisplatin and Chemotherapy [Clinical Trial]. National Institutes of Health Clinical Center. Retrieved from http://clinicaltrials.gov/ct2/show/NCT00004547
  5. Medline Plus (2011). Paclitaxel Injection. Retrieved from http://www.nlm.nih.gov/medlineplus/druginfo/meds/a607070.html#
  6. National Cancer Institute (2011). Cancer Drug Information: Paclitaxel. Retrieved from http://www.cancer.gov/cancertopics/druginfo/paclitaxel
  7. National Cancer Institute (2011). NCI Drug Dictionary: Paclitaxel. Retrieved from http://www.cancer.gov/drugdictionary?CdrID=39762
  8. Stephenson, F. (2002). A Tale of Taxol. Florida State University. Retrieved from http://www.rinr.fsu.edu/fall2002/taxol.html
  9. U.S. Environmental Protection Agency (2004). 2004 Greener Synthetic Pathways Award: Bristol-Myers Squibb Company. Retrieved from http://www.epa.gov/greenchemistry/pubs/pgcc/winners/gspa04.html
  10. Van Meerbeeck, J., et al (1996). Paclitaxel for malignant pleural mesothelioma: a phase II study of the EORTC Lung Cancer Cooperative Group. British Journal of Cancer, 74, 961-963. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2074723/pdf/brjcancer00022-0129.pdf
  11. Vogelzang, N.J., et al (1999). High-dose paclitaxel plus G-CSF for malignant mesothelioma: CALGB phase II study 9234. Annals of Oncology, 10, 597-600. Retrieved from http://annonc.oxfordjournals.org/content/10/5/597.full.pdf

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