Paclitaxel and Docetaxel in Advanced Ovarian Cancer

Abstract

The taxoids, paclitaxel and docetaxel, represent a novel class of antineoplastic drugs. They share similar mechanisms of action, i.e., the promotion of microtubule assembly and the inhibition of microtuble disassembly. ^(1-3) Paclitaxel (Taxol) is a taxane analog extracted from the bark of the Pacific yew, Taxus brevifolia. Docetexel (Taxotere) is a semisynthetic taxoid derived from the needles of the European yew, Taxus baccata. An efficient semisynthetic process using a renewable drug source led to extensive preclinical testing. Although the molecular structures are similar, the toxicity are different. Docetaxel causes cumulative edema but less neuropathy. ⁽⁴⁾ Premedication to prevent anaphylactoid reaction is necessary with both taxoids. For paclitaxel, premedication consists of oral steroids and parenteral diphenhydramine plus cimetidine before drug administration. With docetaxel, oral steroids are started 24 hours before treatment and continued for a total of 5 days. Docetaxel should be administered through tubes not lined with polyvinyl chloride. Both compounds have a significant clinical activity in platinum-resistant ovarian cancer (Table 1, 2).^(5-17)