Regimen

Docetaxel

Used For:

Stage IV breast cancer.
Metastatic non small cell lung cancer.
Non-small cell lung cancer (NSCLC).
Metastatic breast cancer after anthracycline.
Androgen independent prostate cancer.
Ovarian cancer after platinum failure.

Overview:

What is docetaxel? How does docetaxel work? How is docetaxal taken? How effective is it? What are the side effects?

What is docetaxel?

Docetaxel is a chemotherapeutic agent known as a taxane. Taxanes are a range of drugs that all come from a group of trees called yew trees - the scientific name for this group is ''Taxus.'' Docetaxal comes from a product extracted from the European Yew Tree, a renewable variety.

How does docetaxel work?

As with most chemotherapy drugs, docetaxel attacks the ability of cells to divide. Cancer cells divide rapidly and frequently when compared to normal, healthy cells - so they tend to be affected more by drugs that damage the ability to divide. Taxanes interfere with the formation of microtubules, structures in the cell that are vital for cell division. Docetaxel causes the formation of broken, useless microtubules that cannot be dismantled by the cell. Unable to divide, the cell is stranded mid-cycle and dies.

How is docetaxal taken?

Docetaxel can be used alone, as described here, or in combination with other chemotherapeutic drugs. Docetaxel is nearly always given by intravenous infusion - that is, by needle into the vein. The infusion may take some time - often about an hour. Docetaxel is, as a result, nearly always administered in hospital, under the supervision of medical staff. Docetaxel may be given in two kinds of cycles - in one, it is given as a single dose once every three weeks.

In the other, it is given once a week. In either case, people who take docetaxel also must take another drug - dexamethasone - to help prevent side effects such as nausea. Even when this drug does not fully treat nausea or other side effects, it is important as it has been shown to reduce the severity of side effects. When docetaxel is given once a week, dexamethasone is usually given at the same time. When docetaxel is taken once every three weeks, the dexamethasone is usually taken by mouth by the patient at home before coming, and for several days after.

How effective is it?

Docetaxel is known to extend survival in patients with certain types of cancer - particularly breast and prostate cancer. Clinical trials vary in the exact time of extra survival time. Docetaxel has also appears to slow the progression of metastatic disease. Docetaxel has been shown to improve survival when given with other chemotherapy drugs like doxorubicin and cyclophosphamide in so called ''adjuvant'' therapy - this is treatment given after surgery.

What are the side effects?

Docetaxel''s ability to block cell division means that rapidly dividing cells in the bone marrow are unable to do so - this means that cells produced by the bone marrow, particularly new white blood cells that fight infection, can become much reduced in population. This condition - having too few white blood cells - is called neutropaenia, and is a common side effect. It is possible to have an allergic-type reaction to docetaxel which may be very serious - these are called hypersensitivity reactions. The treatment with dexamethasone mentioned above limits these. It is also possible thave rashes following treatment with docetaxel - these most often affect the hands or