What is Paclitaxel used for?

Paclitaxel and Taxotere are taxanes (Taxoids). Taxane is active ingredient from yew tree trunks, bark or needles extract or semi-synthetic. As early as the 1960s that found by the American West yew (Taxus brevis) trunk crude extract has anti-tumor activity. 1971 Walletal isolated paclitaxel, the U.S. National Cancer Institute human cancer cell lines in vitro screening for ovarian cancer, breast cancer and colorectal cancer prominent effect on transplanted animal tumors such as melanoma, lung cancer also significantly inhibited. Thus in 1983 paclitaxel(CAS NO: 33069-62-4) was in clinical studies. Because of its unique mechanism of action, effective for many patients with drug-resistant, paclitaxel became one of the most popular anticancer drugs.

Paclitaxel in 1994 in China's listed, paclitaxel has been made through the review conducted Phase Ⅱ clinical trial.

1. [Usage of Paclitaxel] general clinical use of paclitaxel following procedures:

(1)First ask whether the patient allergies, and view data in white blood cells and platelets. History of allergy and WBC / thrombocytopenia should be used with caution.

(2)Since this drug can cause allergic reactions, the administration 12 hours and 6 hours before taking dexamethasone 20mg, 30 to 60 minutes before the administration to give oral diphenhydramine and cimetidine 300mg 50mg intravenously.

(3)Three commonly used dose of paclitaxel 135 ~ 175mg/m2, the first injection should be added to the saline or 5% glucose solution 500 ~ 1000ml in glass or polyethylene infusion required, the application of a special hose and 0.22μm microporous membrane filtration.

(4)Per 15 minutes after the start of infusion should be measured blood pressure, heart rate, breathing again, watch for allergic reactions.

(5)Generally, it takes 3 hours for once infusion.

(6)After injection blood picture should be checked weekly for at least 2 times, 3 to 4 weeks later, as the case may be repeated.

It can be used with cisplatin, carboplatin, ifosfamide, fluorouracil, doxorubicin, VP-16 and other joint applications, such as low blood applied when G-CSF, or paclitaxel plus G-CSF prophylaxis.

2. Note of Using Paclitaxel

(1)Hematologic toxicity: In order to improve the main factor limiting the dose, usually in the WBC less than 1500/mm3 helper application when G-CSF, platelets less than 30,000 / mm3 should transfusion of blood components.

(2) An allergic reaction: In addition to pre-treatment, but if there is only mild symptoms such as facial flushing, skin reactions, slightly faster heart rate, blood pressure may not have the easing of withdrawal can be slow drip. However, if severe reactions such as low blood pressure, angioedema, dyspnea, body hives happened, should be discontinued and appropriate treatment given. Patients with severe allergies should not be applied again next paclitaxel treatment.

(3)Nervous System: The most common is numb fingers and toes. About 4% of the patients, especially in high doses may appear obvious sensory and motor deficits and reduced tendon reflexes. There have been isolated reports of infusion occurs in grand mal epilepsy.

(4)Cardiovascular: tachycardia and hypotension over a relatively common, generally do not need treatment. But in the first hour of infusion should be closely observed, since except for patients with serious conduction block does not have to observe once every hour.

(5)Joints and muscles: about half of the patients in the medication after 2 to 3 days will feel joint and muscle pain, and the dose-related. It usually takes a few days to recover. Given G-CSF in patients with muscle pain will increase.

(6)Hepatobiliary system: Since most paclitaxel excreted by the bile of patients with hepatobiliary disease should be carefully observed. In thousands of cases the information about 8% of patients with elevated bilirubin, 23% of patients with elevated alkaline phosphatase, aspartate aminotransferase increased with 18%. But there is no information on paclitaxel serious liver damage.

(7)Other: gastrointestinal reactions, although uncommon but generally not heavy, a few may have diarrhea and mucositis. Mild hair loss are more common.

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