title: Treatment regimens of classical and newer taxanes.
abstract: The classical taxanes (paclitaxel, docetaxel), the newer taxane cabazitaxel and the nanoparticle-bound nab-paclitaxel are among the most widely used anticancer drugs. The taxanes share the characteristics of extensive hepatic metabolism and biliary excretion, the need for dose adaptation in patients with liver dysfunction, and a substantial pharmacokinetic variability even after taking into account known covariates. Data from clinical studies suggest that optimal scheduling of the taxanes is dependent not only on the specific taxane compound, but also on the tumor type and line of treatment. Still, the optimal dosing regimen (weekly vs 3 weekly) and optimal dose of the taxanes are controversial, as is the value of pharmacological personalization of taxane dosing. In this article, an overview is given on the pharmacological properties of the taxanes, including metabolism, pharmacokinetics-pharmacodynamics and aspects in the clinical use of taxanes. The latter includes the ongoing debate on the most active and safe regimen, the recommended initial dose and the issue of therapeutic drug dosing.
authors.affiliation: Department of Oncology and Hematology, Cantonal Hospital, Rorschacherstrasse 95, St. Gallen, 9007, Switzerland. markus.joerger@kssg.ch.
authors.forename: Markus
authors.initials: M
authors.lastname: Joerger
mesh_terms: D000418:Albumins / Q000378:metabolism / Q000493:pharmacokinetics; D000970:Antineoplastic Agents / Q000378:metabolism / Q000493:pharmacokinetics; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control; D000077143:Docetaxel; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006801:Humans; D008099:Liver / Q000187:drug effects / Q000378:metabolism; D009369:Neoplasms / Q000145:classification / Q000188:drug therapy*; D017239:Paclitaxel / Q000378:metabolism / Q000493:pharmacokinetics; D043823:Taxoids / Q000145:classification / Q000378:metabolism / Q000493:pharmacokinetics; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000378:metabolism / Q000493:pharmacokinetics
chemical_list: C520255:130-nm albumin-bound paclitaxel; D000418:Albumins; D000970:Antineoplastic Agents; D043823:Taxoids; D050257:Tubulin Modulators; D000077143:Docetaxel; C552428:cabazitaxel; D017239:Paclitaxel
keywords: Cabazitaxel; Docetaxel; Nab-paclitaxel; Paclitaxel; Pharmacokinetics; Therapeutic drug monitoring