Prostate cancer is a malignant disease characterized by the uncontrollable growth of prostate cells. The prostate is a gland present in the male reproductive system, located below the bladder, near the rectum and around the urethra. Its main function is to produce a liquid that is expelled during ejaculation, making the sperm more liquid. While healthy cells usually divide and die, when prostate cancer occurs, the cells start to grow out of control. This affects patients’ reproductive and urinary systems, but there are treatment options to address the disease.
These include watchful waiting, surgery, radiation therapy, cryotherapy, hormone therapy, vaccine treatment, bone-directed treatment, and chemotherapy. The U.S. Food and Drug Administration (FDA) approved the use of the drugs Docetaxel (Taxotere®), Cabazitaxel(Jevtana®), Mitoxantrone (Novantrone®), Estramustine (Emcyt®), Doxorubicin (Adriamycin®), Etoposide (VP-16), Vinblastine (Velban®), Paclitaxel (Taxol®), Carboplatin (Paraplatin®), and Vinorelbine (Navelbine®) for chemotherapy in the US.
How Paclitaxel Works
Paclitaxel is an anti-cancer chemotherapy drug, also known as antineoplastic or cytotoxic. It belongs to a class of medicine called taxane or antimicrotubule agent since it was first developed from plant alkaloids. Antimicrotubule agents like paclitaxel inhibit the microtubule structures within the cell, which are part of the cell’s apparatus for dividing and replicating itself. Therefore, the drug works by attacking the cells during various phases of division and stopping cell division, which provokes cancerous cells to die.
The compound is available as an injection or infusion to be administered intravenously, but there is still no pill form of paclitaxel. The US Food and Drug Administration (FDA) first approved the use of paclitaxel in June 30, 1998 to be commercialized under the brand name Taxol by the company Bristol-Myers Squibb. The first indication of paclitaxel was to be used as first line of treatment in combination with cisplatin for patients with non-small lung cancer, who are not candidates for potentially curative surgery and / or radiation therapy. The dosage and schedule of paclitaxel depends on many factors, including patient’s height, weight, and general health or other health problems, and the type of cancer or condition being treated.
Paclitaxel to Treat Prostate Cancer
Despite being first indicated for patients with lung cancer, numerous studies demonstrated the effectiveness of paclitaxel for the treatment of other types of cancer, including breast, ovarian, lung, bladder, prostate, melanoma, esophageal, as well as other types of solid tumor cancers, Kaposi’s sarcoma, and metastatic adenocarcinoma of the pancreas. “Although their ultimate value in prostate cancer therapy remains to be defined in randomized trials, docetaxel and paclitaxel are active agents in HRPC [metastatic hormone-refractory prostate cancer]. Combination therapies using either of these taxanes plus oral EMP show reproducible antitumor activity that appears to be greater and more durable than that of single-agent treatment,” explained the authors of the study “Paclitaxel and docetaxel in prostate cancer.”
“Although the optimal combination and schedule have not been determined, weekly paclitaxel and EMP and docetaxel given every 3 weeks or by weekly infusion with EMP are useful treatment options for patients with progressive HRPC. (…) the median time to progression of 5 to 6 months for current taxane-based therapies suggests that they will not have major impact on overall survival for patients with HRPC.” There are, however, possible side effects associated with the treatment. These include low blood counts, hair loss, arthralgias and myalgias, peripheral neuropathy, nausea and vomiting, diarrhea, mouth sores, and hypersensitivity reaction, which occur in more than 30% of the patients.
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