RT Book, Section A1 Chabner, Bruce A. A2 Chabner, Bruce A. A2 Longo, Dan L. SR Print(0) ID 1127646363 T1 The Taxanes, Vinca Alkaloids, and Their Derivatives T2 Harrison's Manual of Oncology, 2e YR 2016 FD 2016 PB McGraw-Hill Education PP New York, NY SN 9780071793254 LK hemonc.mhmedical.com/content.aspx?aid=1127646363 RD 2024/11/05 AB In the past decade, the taxanes have emerged as one of the most powerful classes of anticancer drugs (1). Two unmodified taxanes, paclitaxel and docetaxel, are approved for clinical use in multiple tumors. An albumin-stabilized paclitaxel (abraxane) is also available for treatment of breast cancer (2), and a new analogue, cabazitaxel, is approved for hormone refractory prostate cancer. Despite their similar structures and a common mechanism of action (disruption of microtubule function), the taxanes differ in their pharmacological profiles, toxicity, and their patterns of clinical activity. Taxanes are predominantly employed in solid tumor chemotherapy in combination with platinum derivatives, with other cytotoxics, or with monoclonal antibodies such as Herceptin (trastuzumab). Both unmodified taxanes act synergistically with trastuzumab against HER2/neu overexpressed breast cancer cells in vitro and in vivo, and the combination of taxane and trastuzumab improves survival against HER2/neu amplified breast cancer in the adjuvant setting. The two original taxanes differ in their interaction with doxorubicin, paclitaxel potentiating the anthracycline's cardiac toxicity, while docetaxel and doxorubicin are well tolerated and highly active in combination (3). The taxanes are also primary agents for treating other malignancies, including ovarian, lung, and bladder cancer.