Docetaxel

Products

Docetaxel is commercially available as an infusion preparation (Taxotere, generics). It was approved in many countries in 1996 as a second taxane after paclitaxel (Taxol).

Structure and properties

Docetaxel (C₄₃H₅₃NO₁₄, M_r = 807.9 g/mol) is present in the drug as docetaxel trihydrate, a white powder that is practically insoluble in water. The lipophilic drug is semisynthetically prepared from ingredients of the European yew tree. It is a derivative of paclitaxel (Taxol), differing from it structurally at two positions.

Effects

Docetaxel (ATC L01CD02) has antitumor, cytostatic, and antimitotic properties. It inhibits mitosis and thereby cell division. The effects are due to disruption of the microtubule network.

Indications

In many countries, docetaxel is approved for the following indications:

• Breast cancer
• Non-small cell bronchial carcinoma
• Prostate cancer
• Adenocarcinoma of the stomach
• Squamous cell carcinoma of the ENT region

Dosage

According to the professional information. The drug is administered as an intravenous infusion.

Contraindications

• Severe hypersensitivity
• Neutropenia
• Pregnancy and lactation
• Severe hepatic insufficiency

Full precautions can be found in the drug label.

Interactions

Docetaxel is a substrate of CYP3A and corresponding drug-drug interactions with CYP inhibitors and inducers have been described.

Adverse effects

The most common potential adverse effects include:

• Lack of appetite, diarrhea, nausea, vomiting, oral mucositis.
• Muscle and joint pain
• Fatigue, weakness, pain
• Increase in liver enzymes
• Skin rash, hair loss
• Fever, flu-like symptoms
• Infectious diseases
• Blood count disorders, e.g. neutropenia, anemia, thrombocytopenia (bone marrow toxicity).