Paclitaxel (Taxol)

Indications

Breast Cancer (see Breast Cancer, [[Breast Cancer]])
Lung Cancer (see Lung Cancer, [[Lung Cancer]])
Ovarian Cancer (see Ovarian Cancer, [[Ovarian Cancer]])

Pharmacology

Taxane (see Taxanes, [[Taxanes]]): taxanes are diterpenes produced by the plants of the genus Taxus (yews)
- Docetaxel (Taxotere) (see Docetaxel, [[Docetaxel]])
- Paclitaxel (Taxol)

Administration

xxx

Adverse Effects

Pulmonary Adverse Effects

Acute Hypersensitivity Reaction with Bronchospasm (see Obstructive Lung Disease, [[Obstructive Lung Disease]])

Epidemiology: occurs in up to 30% of cases
- Studies in thoracic malignancies report early toxicity of 10% and late toxicity of 68% -> however, determination of effect of paclitxel itself is confounded by thoracic neoplasm and other chemo agents administered
Physiology: likely due to IgE antibodies present against either paclitaxel or its vehicle, cermophor EL
Clinical: bronchospasm, angioedema
Treatment: pre-medication with steroids may be helpful

Subacute Interstitial Pneumonitis (see Interstitial Lung Disease-Etiology, [[Interstitial Lung Disease-Etiology]])

Diagnosis
- PFT’s: decreased DLCO may be seen without radiographic changes
- CXR/Chest CT: interstitial and reticulonodular infiltrates

Drug-Induced Pulmonary Eosinophilia (see Drug-Induced Pulmonary Eosinophilia, [[Drug-Induced Pulmonary Eosinophilia]])

Clinical: xxx

Other Adverse Effects

xxx
xxx
xxx

References

Pneumonitis related to treatment with paclitaxel. J Clin Oncol 1995; 13: 534
Radiation recall dermatitis and pneumonitis in a patient treated with paclitaxel. Cancer 1995; 76: 1069-1072
Paclitaxel-induced severe hypersensitivity reaction occurring as a late toxicity. Ann Oncol 1995; 6: 852
Transient pulmonary infiltrates: a hypersensitivity reaction to Paclitaxel. Ann Intern Med 1996; 124: 278
Pulmonary infiltrates following administration of paclitaxel. Chest 1996; 110: 289-292
Severe lymphocytopenia and interstitial pneumonia in patients treated with paclitaxel and simultaneous radiotherapy for non-small-cell lung cancer. J Clin Oncol 1996; 14: 1071-1076
Pulmonary changes in patients with lymphoma who receive paclitaxel. J Clin Oncol 1997; 15: 2476
Postoperative bronchopulmonary complications in stage III lung cancer patients treated with preoperative paclitaxel-containing chemotherapy and concurrent radiation. Semin Oncol 1997; 24: 123-129
Paclitaxel-induced bilateral pneumonitis. Ann Pharmacother 1997; 31: 1471-1474
Paclitaxel-induced cell-mediated hypersensitivity pneumonitis. Diagnosis using leukocyte migration test, bronchoalveolar lavage and transbronchial lung biopsy. Oncology 1998; 55: 340-344
Gemcitabine and paclitaxel associated pneumonitis in non-small cell lung cancer: report of a phase I/II dose- escalating study. European Journal of Cancer 2000; 36: 2329-2334
Paclitaxel-induced hypersensitivity pneumonitis: Radiographic and CT findings. American Journal of Roentgenology 2001; 176: 718-720