Paclitaxel, also known by the brand name Taxol, has been successfully used to treat a variety of cancers. However, the chemotherapeutic drug has received mixed reviews for treating mesothelioma. Paclitaxel is most effective when used as part of a multimodal treatment plan.
Paclitaxel (Taxol) is approved by the Food and Drug Administration (FDA) for use against breast cancer, non-small cell lung cancer and ovarian cancer.
Despite the drug’s success in treating these cancers, past clinical trials in mesothelioma patients have had less than ideal outcomes, with most patients experiencing no benefits. Doctors believe paclitaxel, like cisplatin and carboplatin, will work best when combined with other treatments such as surgery, radiation therapy and other chemotherapy drugs.
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.
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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.
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.
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.
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