BOX WARNING
WARNING
Paclitaxel Injection should be administered under the supervision of a physician experienced in the use of cancer chemotherapeutic agents. Appropriate management of complications is possible only when adequate diagnostic and treatment facilities are readily available.
Anaphylaxis and severe hypersensitivity reactions characterized by dyspnea and hypotension requiring treatment, angioedema, and generalized urticaria have occurred in 2% to 4% of patients receiving paclitaxel in clinical trials. Fatal reactions have occurred in patients despite premedication. All patients should be pretreated with corticosteroids, diphenhydramine, and H2 antagonists. (See DOSAGE AND ADMINISTRATION.) Patients who experience severe hypersensitivity reactions to paclitaxel should not be rechallenged with the drug.
Paclitaxel therapy should not be given to patients with solid tumors who have baseline neutrophil counts of less than 1,500 cells/mm3 and should not be given to patients with AIDS-related Kaposi's sarcoma if the baseline neutrophil count is less than 1000 cells/mm3. In order to monitor the occurrence of bone marrow suppression, primarily neutropenia, which may be severe and result in infection, it is recommended that frequent peripheral blood cell counts be performed on all patients receiving paclitaxel.
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PACLITAXEL SUMMARY
PACLITAXEL INJECTION USP
Paclitaxel Injection is a clear colorless to slightly yellow viscous solution. It is supplied as a nonaqueous solution intended for dilution with a suitable parenteral fluid prior to intravenous infusion.
Paclitaxel Injection is indicated as subsequent therapy for the treatment of advanced carcinoma of the ovary.
Paclitaxel Injection is indicated for the treatment of breast cancer after failure of combination chemotherapy for metastatic disease or relapse within 6 months of adjuvant chemotherapy. Prior therapy should have included an anthracycline unless clinically contraindicated.
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NEWS HIGHLIGHTSMedia Articles Related to Paclitaxel
FDA Expands Agent's Orphan Drug Status
Source: MedPage Today Product Alert [2009.11.05]
WASHINGTON (MedPage Today) -- The FDA has extended the orphan drug status of the breast cancer agent protein-bound paclitaxel (Abraxane) for use in stage IIB-IV melanoma treatment.
Published Studies Related to Paclitaxel
A Phase II, Randomized, Controlled, Double-Blinded Trial of Weekly Elesclomol Plus Paclitaxel Versus Paclitaxel Alone for Stage IV Metastatic Melanoma. [2009.10.13]
PURPOSE: Elesclomol is a novel, small-molecule, oxidative stress inducer believed to exert selective cytotoxicity by increasing intracellular concentrations of reactive oxygen species, which results in cell death via mitochondrial apoptosis. We evaluated whether the addition of elesclomol to weekly paclitaxel could improve efficacy in patients with stage IV metastatic melanoma... CONCLUSION: E + P resulted in a statistically significant doubling of median PFS, with an acceptable toxicity profile and encouraging OS. A multinational, phase III trial (SYMMETRY) of E + P compared with paclitaxel alone in metastatic melanoma has closed.
Final 5-year results of the TAXUS II trial: a randomized study to assess the effectiveness of slow- and moderate-release polymer-based paclitaxel-eluting stents for de novo coronary artery lesions. [2009.10.13]
CONCLUSIONS: TAXUS II is the first large TAXUS trial to have reached 5-year follow-up. Both the SR and MR stents lowered the rates of target-vessel and target-lesion revascularization, which indicates their sustained efficacy. Furthermore, the low overall rates of all death, myocardial infarction, and stent thrombosis support the long-term safety of the TAXUS stent system.
A Phase III Trial of Paclitaxel plus Carboplatin Versus Paclitaxel plus Cisplatin in Stage IVB, Persistent or Recurrent Cervical Cancer: Gynecologic Cancer Study Group/Japan Clinical Oncology Group Study (JCOG0505). [2009.10.12]
A randomized controlled trial has been started in Japan to compare the utility of palliative chemotherapy containing paclitaxel and carboplatin (TC) with paclitaxel and cisplatin (TP) as a standard treatment for patients with the newly diagnosed Stage IVB, persistent or recurrent cervical cancer who are not amenable to curative treatment with local therapy...
SPIRIT IV trial design: a large-scale randomized comparison of everolimus-eluting stents and paclitaxel-eluting stents in patients with coronary artery disease. [2009.10]
BACKGROUND: In the 300-patient SPIRIT II and 1002-patient SPIRIT III randomized trials, the everolimus-eluting stent (EES) compared to the paclitaxel-eluting stent (PES) resulted in reduced angiographic late loss (a primary end point in both trials), noninferior rates of 9-month target vessel failure (a primary end point in SPIRIT III), and reduced rates of target lesion revascularization and major adverse cardiac events (secondary end points)...
Long-Term outcome of drug-eluting stents compared with bare metal stents in ST-segment elevation myocardial infarction: results of the paclitaxel- or sirolimus-eluting stent versus bare metal stent in Primary Angioplasty (PASEO) Randomized Trial. [2009.09.15]
CONCLUSIONS: This study shows that among STEMI patients undergoing primary angioplasty, both SES and PES are associated with significant benefits in terms of target lesion revascularization at the long-term follow-up compared with BMS with no excess risk of thrombotic complications. Thus, until the results of further large randomized trials with long-term follow-up become available, drug-eluting stents may be considered among STEMI patients undergoing primary angioplasty.
Clinical Trials Related to Paclitaxel
Comparison of Liposome Entrapped Paclitaxel Easy to Use (LEP-ETU) and Taxol® Pharmacokinetics in Patients With Advanced Cancer [Active, not recruiting]
In this study, Liposome Entrapped Paclitaxel Easy to Use (LEP-ETU) is being compared to
Taxol® to examine whether the paclitaxel in these 2 formulations undergoes similar processing
by the body. Safety and tolerability of LEP-ETU and Taxol will also be assessed. In this
study, each patient will receive one intravenous infusion of LEP-ETU or Taxol, followed 3
weeks later by an infusion of the other drug, at the same dose and infusion duration.
Multiple blood samples will be taken for analysis before, during, and after both drug
infusions. Upon completing these 2 Cycles of treatment, eligible patients may enroll in an
extension study (LEP-ETU-102B) to continue treatment with LEP-ETU.
LEP-ETU is a liposomal formulation of paclitaxel, a widely used anti-cancer drug. This
LEP-ETU formulation of paclitaxel is being developed to potentially reduce toxicities
associated with Taxol, by eliminating the drug formulation component polyoxyethylated castor
oil (Cremophor® EL). In LEP-ETU, paclitaxel is associated with liposomes, which are
microscopic membrane-like structures created from lipids (fats). Thus, the LEP-ETU
formulation could potentially have reduced toxicity, while maintaining or enhancing
efficacy.
Use of Nanoparticle Paclitaxel (ABI-007) for the Prevention of In-Stent Restenosis [Active, not recruiting]
The purpose of this study is to investigate the use of systemic intracoronary administration
of albumin-bound paclitaxel, ABI-007, for the prevention and reduction of restenosis
following de novo stenting or following angioplasty for in-stent restenosis.
Randomized Ph 2 Trial Of Paclitaxel/Carboplatin /Bevacizumab + PF-3512676 And P/C/B Alone In Advanced Nonsquamous NSCLC [Active, not recruiting]
To assess the efficacy and safety of PF-3512676 administered in combination with paclitaxel,
carboplatin and bevacizumab as first-line treatment in patients with locally advanced or
metastatic nonsquamous non-small cell lung cancer
Combination Chemotherapy, Bevacizumab, Radiation Therapy, and Erlotinib in Treating Patients With Stage III Non-Small Cell Lung Cancer [Recruiting]
RATIONALE: Drugs used in chemotherapy, such as carboplatin and paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Monoclonal antibodies, such as bevacizumab, can block tumor growth in different ways. Some block the ability of tumor cells to grow and spread. Others find tumor cells and help kill them or carry tumor-killing substances to them. Bevacizumab may also stop the growth of non-small cell lung cancer by blocking blood flow to the tumor. Radiation therapy uses high energy x-rays to kill tumor cells. Erlotinib may stop the growth of tumor cells by blocking some of the enzymes needed for cell growth. Giving combination chemotherapy together with bevacizumab, radiation therapy, and erlotinib may kill more tumor cells.
PURPOSE: This phase I/II trial is studying the side effects and best dose of bevacizumab and erlotinib when given together with combination chemotherapy and radiation therapy and to see how well they work in treating patients with stage III non-small cell lung cancer.
Paclitaxel and ABI-007 in Treating Patients With Locally Advanced or Metastatic Solid Tumors [Active, not recruiting]
RATIONALE: Drugs used in chemotherapy, such as paclitaxel and ABI-007, work in different ways
to stop tumor cells from dividing so they stop growing or die. Combining paclitaxel with
ABI-007 may kill more tumor cells.
PURPOSE: Randomized phase I trial to study the effectiveness of combining paclitaxel with
ABI-007 in treating patients who have locally advanced or metastatic solid tumors.
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Page last updated: 2009-11-05
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