title: Paclitaxel: severe mucocutaneous toxicity in a patient with hyperbilirubinemia.
abstract: Paclitaxel is a novel anticancer drug that is being increasingly used to treat cancer of the breast and other organs. We describe a patient with metastatic breast cancer and liver dysfunction who had severe mucocutaneous toxicity after administration of a standard dose of paclitaxel. Another interesting finding in this patient was that the administration of paclitaxel led to a prompt resolution of parathyroid hormone-related protein (PTHrP)-mediated hypercalcemia, which had previously proven to be refractory to multiple conventional antihypercalcemic agents as well as anthracycline-containing chemotherapy combination. The need for definitive guidelines for paclitaxel administration in the setting of hepatic dysfunction and the potentially unique sensitivity of PTHrP--producing cells to paclitaxel are discussed.
authors.affiliation: Department of Breast and Gynecologic Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, 77030, USA.
authors.forename: J Y
authors.initials: JY
authors.lastname: Payne
authors.forename: F
authors.initials: F
authors.lastname: Holmes
authors.forename: P R
authors.initials: PR
authors.lastname: Cohen
authors.forename: R
authors.initials: R
authors.lastname: Gagel
authors.forename: A
authors.initials: A
authors.lastname: Buzdar
authors.forename: K
authors.initials: K
authors.lastname: Dhingra
mesh_terms: D018943:Anthracyclines / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000556:secondary; D003875:Drug Eruptions / Q000209:etiology*; D004892:Erythema Multiforme / Q000139:chemically induced*; D005260:Female; D006801:Humans; D006932:Hyperbilirubinemia / Q000150:complications*; D006934:Hypercalcemia / Q000188:drug therapy; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008875:Middle Aged; D009059:Mouth Diseases / Q000139:chemically induced; D009363:Neoplasm Proteins / Q000037:antagonists & inhibitors; D017239:Paclitaxel / Q000009:adverse effects*; D010281:Parathyroid Hormone / Q000037:antagonists & inhibitors; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins / Q000037:antagonists & inhibitors; D014623:Vaginal Diseases / Q000139:chemically induced
chemical_list: D018943:Anthracyclines; D000972:Antineoplastic Agents, Phytogenic; D009363:Neoplasm Proteins; C470121:PTHLH protein, human; D010281:Parathyroid Hormone; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins; D017239:Paclitaxel