Docetaxel review

Docetaxel is clinically tested anti-mitotic chemotherapy drug. It has been considered better than doxorubicin, paclitaxel and fluorouracil as cytotoxic antimicrotubule agents.

Docetaxel belongs to the chemotherapy drug class. One of its components taxane, is a semi-synthetic counterpart of paclitaxel, extracted from the rare yew tree of the Pacific Taxus brevifolia. Due to paclitaxel’s rarity, extensive research brought about docetaxel, which is obtained from the European yew tree.

Docetaxel, marketed with its brand name Taxotere is used for cancer treatments. It is medication used when chemotherapy regimens fail. Breast cancer, ovarian cancer and non small-cell lung cancer which has undergone anthracycline based chemotherapy but failed, or have relapsed is treated with docetaxel. Tacoter is also used to treat androgen independent prostate cancer.

Docetaxel, or taxotere, is an injectable drug concentrate that is sterile and non-pyrogenic. It is available in single dose vials with 20mg or 80mg of docetaxel. Every mL contains 40mg docetaxel and 1040 mg polysorbate 80. Taxotere requires dilution before usage. Administration should be a one-hour infusion every three weeks over a course of ten cycles.

Docetaxel is known to inhibit mitosis and also found out to regress tumors because of its function that leads to the phosphorylation of oncoprotein bcl-2 that leads to the apoptosis of cancer cells. Compared to paclitaxel, docetaxel has been found to have better cellular uptake and is retained longer intracellularly, allowing for use of lesser doses, for lesser adverse effects.

As docetaxel is a chemotherapeutic agent, it is also a biologically damaging drug. Because docetaxel is a cell cycle specific agent, it has cytotoxic effects throughout all the cells of the body, ranging from tumor cells to skin cells, bone marrow and other germ cells. Alopecia may occur, which may be permanent, leaving women disfigured.

Docetaxel may also result in some hematological side effects such as neutropenia, febrile neutropenia, anemia, and thrombocytopenia. Patients with liver dysfunction have been found to be more susceptible to death.

Docetaxel is contraindicated for patients with histories of hypersensitivity to polysorbate 80 or docetaxel. Liver impairment, pregnant women, and patients with a baseline neutrophil count of 1500 cells/µL or below are also contraindications of docetaxel.

Prior to the administration of the docetaxel injection, the doctor must be informed whether the patient is allergic to the drug or other medication. The doctor must also be informed of other medication the patient takes, as some of them may interfere or interact adversely with docetaxel. Pregnant women and nursing mothers are not advised to take docetaxel as it may have adverse effects to the fetus and the nursing infant. Any kind of surgery must also be reported to the administering doctor.

Drug interaction of docetaxel may result in the pharmacokinetics of the drug. Cisplatin, a drug commonly co-administered with docetaxel has been found out to have no modifying effects to the binding ability of docetaxel in blood plasma. CYP3A4 inhibitors such as erythromycin and ketoconazole inhibit the metabolic pathways of docetaxel. In such cases, docetaxel dosages must be increased.

Docetaxel has the following structural formula:

Chemical structure of docetaxel

• Molecular formula of docetaxel is C43H53NO14

Brand name(s): Taxotere

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