One patient with extensive hepatic metastases died of autopsy-proven pulmonary microvascular carcinomatosis 18 hours after a first paclitaxel infusion. The resilience of myeloid precursors to repeated exposure to paclitaxel at this dose and schedule suggests that it is possible to uncouple drug delivery from bone marrow suppression. The complete absence of febrile neutropenia and relatively shallow leukocyte nadirs permitted chronic weekly therapy without treatment interruption or growth factor support.
Cellular cytokinetic considerations imply that the shorter intertreatment intervals characteristic of dose-dense therapy should allow less opportunity for the emergence of drug-resistant clones.
Laboratory investigations are actively studying this issue. The preliminary safety and high therapeutic index of paclitaxel via 1-hour weekly infusion increases therapeutic options for patients with breast cancer. Whether as monotherapy or in combination, this strategy deserves further exploration in the treatment of breast cancer.
Cancer Chemother Pharmacol , Br J Cancer , J Clin Oncol , Chang AY, Boros L, Garrow R, et al: Paclitaxel by 3-hour infusion followed by hour infusion on failure in patients with refractory malignant disease. Semin Oncol 22 suppl 6 : , Philadelphia, Lippincott-Raven, Fennelly D, Aghajanian C, Shapiro F, et al: Phase I and pharmacologic study of paclitaxel administered weekly in patients with relapsed ovarian cancer.
Cancer J Sci Am , Cancer Treat Res Rep , Proc Am Soc Clin Oncol a, Proc Am Assoc Cancer Res , January 1, Andrew D. Taxol is a clear, colorless fluid that's mixed with Cremophor EL polyoxyethylated castor oil and given by infusion —in other words, it's administered directly into a vein. It is thick and sticky, so a pump is necessary to properly infuse it. As such, you'll have to go to a hospital or clinic to receive it.
It can be given as high-dose chemo, once every two or three weeks, or in low doses once a week. In some cases, Taxol is given slowly over the course of 24 hours. The amount of Taxol you are prescribed depends on many factors, including your height and weight, your general health, and the type of cancer or condition being treated.
A healthcare provider must administer Taxol; if not administered properly, it can cause tissue damage. Medications such as Benadryl diphenhydramine are given before and during infusion of Taxol to reduce the risk of an allergic reaction. Most people tolerate Taxol well, especially in low doses. It does have side effects, however, which include:. There are ways to prevent some of the problems these side effects can cause. Before you begin treatment with Taxol, your healthcare provider will probably have you take supplements of an amino acid called L-glutamine to reduce your risk of neuropathy.
It has also become increasingly common to receive injections of either Neupogen filgrastim or Neulasta pegfilgrastim to boost white blood cell counts. These must be given at least 24 hours after your chemotherapy infusion has been completed, but early enough to stimulate formation of white blood cells before they hit their lowest point called the nadir.
Furthermore, to avoid risky interactions, you will be advised not to drink alcohol while you're being treated with Taxol, and to avoid medications that include aspirin.
Most side effects of chemotherapy resolve rapidly after treatment is completed, although some long-term side effects of chemotherapy may persist. In particular, peripheral neuropathy may sometimes be permanent, and fatigue may sometimes take years to fully improve.
If taken during pregnancy, Taxol can potentially harm a developing fetus. It should not be used by pregnant women; if you are not pregnant and are sexually active, you'll have to use birth control while you are on Taxol. Taxol can be passed through breast milk, so you will not be able to breastfeed. Taxol is associated with future infertility. Talk to your healthcare provider before beginning therapy if you plan to become pregnant.
Since chemotherapy drugs compromise the immune system, some vaccines live vaccines are not recommended while you are undergoing Taxol treatment. Killed vaccines such as the flu shot, but not the oral preparation are, however, often recommended. That said, vaccines may not work as well as usual when you are receiving chemotherapy. You will be susceptible to infections while on Taxol, which can often become very serious—even life-threatening.
This risk may be present even if you are also receiving Neulasta or Neupogen. Call your healthcare provider immediately if you develop a fever, chills, pain, or notice redness or swelling at the infusion site. Some people may have an allergic reaction to Taxol or to Cremophor EL, and therefore should avoid this drug.
As with any form of chemotherapy, Taxol can take a toll on your energy. Try to eat healthily, exercise when you can, and get adequate rest during treatment. Learn to ask for, and accept help. Keep in mind that one of the most common complaints of loved ones of people coping with cancer is a sense of helplessness. Allowing your loved one to help you may not only help deal with the fatigue of treatment, but help them better cope as well.
Get honest information, the latest research, and support for you or a loved one with breast cancer right to your inbox. American Cancer Society. For women diagnosed with early-stage, lymph-node-positive breast cancer, treatment often includes chemotherapy with Adriamycin and Cytoxan followed by a taxane.
This chemotherapy regimen is sometimes called AC followed by T. Taxol, Taxotere, and Abraxane chemical name: albumin-bound or nab-paclitaxel are all taxanes. In the AC followed by T regimen, a taxane is usually given as 4 treatments over 12 weeks -- 1 treatment every 3 weeks.
In this study, the researchers compared the usual schedule of giving Taxol or Taxotere every 3 weeks to a different schedule that gave a lower dose of Taxol or Taxotere every week for 12 weeks. The women who got Taxol every week also were more likely to be alive 5 years after diagnosis compared to women who got Taxotere either weekly or every 3 weeks.
Abraxane was not looked at in this study. Some doctors have wondered whether a taxane has benefits for women diagnosed with hormone-receptor-positive breast cancer.
This study found that women diagnosed with hormone-receptor-positive breast cancer did benefit from getting a taxane. Women who got Taxol or Taxotere once a week instead of every 3 weeks seemed to have less severe side effects from the chemotherapy.
0コメント