While it is helpful to understand why both drugs were developed, many people now ask, what the medical difference between paclitaxel Taxol and docetaxel Taxotere. Often, women with breast cancer are given the choice between multiple chemotherapy treatments available.
Different oncologists may recommend competing therapies, and it can be difficult for patients to make a decision when there is no clear rubric to help them decide. A doctor can help a patient to weigh the pros and cons between two or three drug combinations, but, in the end, a patient has to commit to one course of treatment.
Having all the available information about the risks and benefits of each drug is essential to making a personal and empowered decision. One major difference between Taxol paclitaxel and Taxotere docetaxel is the solution in which these two chemicals are dissolved for infusion into the body.
Taxol is dissolved in polyoxyethylated castor oil and alcohol, while Taxotere is dissolved in polysorbate 80 and alcohol. If a patient has an allergy to either castor oil or polysorbate, their doctor will most likely recommend the alternative drug. There is contradictory and competing evidence concerning the comparative effectiveness of Taxol and Taxotere. Early studies indicated that Taxotere might be more aggressive and successful at eliminating cancerous cells in the body because the drug could infiltrate the cell at higher levels than Taxol.
However, this was merely a hypothesis at the time that Taxotere was released on the market, and long-term studies have not corroborated this initial indication. Both paclitaxel Taxol and docetaxel Taxotere are highly effective at treating breast cancer, and both work by attacking the skeletons of cells, preventing them from dividing. Multiple long-term studies have proven that there is no statistical difference in survival rates between Taxol and Taxotere for the treatment of breast cancer that has spread to the lymph nodes or presents the risk of spreading.
One study, in particular , published in the New England Journal of Medicine in , included women and lasted nearly ten years. The study had four groups.
One group was given paclitaxel Taxol weekly, one was given paclitaxel Taxol every three weeks at higher doses, one was given docetaxel Taxotere weekly, and the last was given docetaxel Taxotere every three weeks. While Taxotere performed better than non-taxane drugs, it was not directly studied in comparison to paclitaxel Taxol. Furthermore, promotional materials are misleading if they contain representations that the drug is better or more effective than has been demonstrated by substantial evidence or substantial clinical experience.
The FDA states that they know of no clinical evidence that supports these claims and asks for substantiation from Sanofi-Aventis. In conclusion, the governmental organization demands that Sanofi-Aventis respond with a full list of all promotional materials for Taxotere and a plan for discontinuing the materials that make the unsubstantiated claim. Sparano, MD , professor of medicine and women's health at Albert Einstein College of Medicine, and colleagues evaluated various regimens in 4, women with axillary node-positive or high-risk node-negative breast cancer.
Previously released results, based on a median 5. The current analysis occurred after a median The numbers of DFS events vs. Patients who were ER-positive also received endocrine therapy for 5 or more years.
Obesity also was associated with a greater risk for recurrence 3 to 8 years after diagnosis. The clinical benefit of solvent-based taxanes, including solvent-based paclitaxel and docetaxel, in MBC has been established in large randomized clinical trials.
Docetaxel has demonstrated greater efficacy versus solvent-based paclitaxel in at least one trial, but both solvent-based paclitaxel and docetaxel are associated with undesirable dose-limiting toxicities, including neutropenia, sensory neuropathy, and hypersensitivity reactions.
This review summarizes preclinical experiments and clinical data from MBC trials comparing nab-paclitaxel with docetaxel. Clinical studies confirmed these findings and reported a better therapeutic index with nab-paclitaxel than docetaxel. As such, the clinical experience with nabpaclitaxel supports its role as an important advance in the treatment of MBC with taxane-based regimens.
The authors are fully responsible for content and editorial decisions for this manuscript. Taxane-based treatment regimens are standard first-line therapies for metastatic breast cancer MBC , 1 the second most common cause of cancer deaths among women in the US. The potent anticancer activity of taxanes stems from their capacity to inhibit microtubule dynamics by binding directly to b-tubulin subunits see Figure 1. In doing so, taxanes promote microtubule polymerization, inhibit microtubule depolymerization, and enhance microtubule stability.
Consequently, taxanes induce cell death by disrupting mitotic spindle formation during the G2 and M phases of the cell cycle. This article describes the clinical experience to date with solvent-based taxanes from large pivotal phase III trials of patients with MBC with a particular emphasis on the toxicity challenges associated with these agents.
The rationale for the development of nab-paclitaxel and its unique mechanism of delivery are also described.
Finally, preclinical and clinical studies of nab-paclitaxel and docetaxel in MBC are reviewed. History of Taxane Development Solvent-based Paclitaxel Paclitaxel was discovered as a result of a large-scale effort by the National Cancer Institute to identify plant extracts with antitumor properties in the s. As paclitaxel is extremely hydrophobic, it is difficult to solubilize.
Its insolubility, together with the potential difficulties in harvesting a limited natural resource, nearly thwarted the clinical development of paclitaxel. It was reported in early trials of solvent-based paclitaxel that the taxanes had similar efficacy to anthracyclines, the standard of care for MBC at the time. Despite the promising clinical activity described above, it became clear that treatment with solvent-based paclitaxel exposed patients to peripheral neuropathy, hypersensitivity reactions, and neutropenia.
In addition to inducing hypersensitivity reactions and contributing to the risk for peripheral neuropathy in some patients, 8 CrEL also limits the pharmacokinetics of solvent-based paclitaxel.
Docetaxel Docetaxel, a semisynthetic analog of paclitaxel, was developed in an effort to overcome the challenges associated with harvesting sufficient amounts of a natural resource for cancer research relative to the starting material originally required for paclitaxel.
Similar to paclitaxel, docetaxel is difficult to solubilize. Tween is similar to CrEL in that it is also thought to form micelle-like structures, which influence docetaxel pharmacokinetics. Docetaxel achieved a significantly higher ORR To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below.
For general information, Learn About Clinical Studies. Histologically proven metastatic or locally advanced, inoperable adenocarcinoma of the breast. Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information. Search for terms. Save this study. Warning You have reached the maximum number of saved studies Paclitaxel or Docetaxel in Treating Women With Advanced Breast Cancer The safety and scientific validity of this study is the responsibility of the study sponsor and investigators.
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Detailed Description:. Compare the toxicity of these regimens in these patients.
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