Managing taxane toxicities.
The two commercially available taxanes (paclitaxel and docetaxel) are widely employed in standard oncologic practice. Toxicity of the agents includes bone marrow suppression (principally neutropenia), complete alopecia, and hypersensitivity reactions. While both drugs can cause neurotoxicity and myalgias/arthralgias, this is a greater clinical concern with paclitaxel. Docetaxel can be associated with the development of significant fluid retention (e.g., edema, ascites, pleural effusions), the incidence and severity of which appear to be limited by prophylactic treatment with corticosteroids both before and after each treatment. If patients are monitored closely (e.g., for hypersensitivity reactions, bone marrow suppression) the taxanes have a favorable side effect profile, and it is currently uncommon for treatment to be discontinued because of the development of excessive toxicity.
Markman
Maurie
M
Department of Hematology/Medical Oncology (R35), The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA. markmam@ccf.org
D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects*; D018771:Arthralgia / Q000139:chemically induced / Q000628:therapy; D001952:Bridged-Ring Compounds / Q000009:adverse effects*; D000077143:Docetaxel; D004342:Drug Hypersensitivity / Q000209:etiology / Q000628:therapy; D006801:Humans; D009503:Neutropenia / Q000139:chemically induced / Q000628:therapy; D017239:Paclitaxel / Q000009:adverse effects* / Q000031:analogs & derivatives*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000628:therapy; D043823:Taxoids; D013921:Thrombocytopenia / Q000139:chemically induced / Q000628:therapy
D000972:Antineoplastic Agents, Phytogenic; D001952:Bridged-Ring Compounds; D043823:Taxoids; D000077143:Docetaxel; C080625:taxane; D017239:Paclitaxel