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 2024/04/23
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.