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Paclitaxel and docetaxel in prostate cancer.
- Source :
-
Hematology/oncology clinics of North America [Hematol Oncol Clin North Am] 2001 Jun; Vol. 15 (3), pp. 525-45. - Publication Year :
- 2001
-
Abstract
- Although their ultimate value in prostate cancer therapy remains to be defined in randomized trials, docetaxel and paclitaxel are active agents in HRPC. 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. 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 gastrointestinal toxicity of EMP has been reduced by intermittent rather than continuous administration, and other toxicities may be reduced further by use of intravenous EMP. Although there has been progress, 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. Greater benefit may be possible earlier in the course of prostate cancer, and the activity of the taxane-EMP combinations is sufficient to justify clinical trials of adjuvant or neoadjuvant chemotherapy for selected groups of patients with locally advanced and poor-prognosis tumors. Armed with many new molecularly targeted agents that may interact favorably with taxanes, it should be possible to build on current antimicrotubule regimens to improve activity in HRPC. Taxane-EMP combinations provide a platform on which to test additional agents that may enhance the apoptotic response or circumvent cellular stress adaptations that confer drug resistance. Further elucidation of signaling pathways that regulate microtubule dynamics and programmed cell death after exposure to microtubule inhibitors would provide a more rational guide for integrating specific inhibitors of signal transduction with current taxane-based therapies. Pharmacokinetic and pharmacodynamic studies will play a key role in the development of future taxane-based therapies for prostate cancer.
- Subjects :
- Antineoplastic Agents, Phytogenic pharmacology
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Apoptosis drug effects
Carboplatin administration & dosage
Chemotherapy, Adjuvant
Clinical Trials, Phase I as Topic
Clinical Trials, Phase II as Topic
Dexamethasone administration & dosage
Docetaxel
Drug Administration Schedule
Drug Resistance, Neoplasm
Enzyme Inhibitors administration & dosage
Enzyme Inhibitors pharmacology
Enzyme Inhibitors therapeutic use
Estramustine administration & dosage
Etoposide administration & dosage
Genes, bcl-2
Humans
Hydrocortisone administration & dosage
Male
Mitosis drug effects
Mitoxantrone administration & dosage
Multicenter Studies as Topic
Neoplasm Proteins antagonists & inhibitors
Neoplasm Proteins genetics
Neoplasm Proteins metabolism
Oligodeoxyribonucleotides, Antisense therapeutic use
Paclitaxel administration & dosage
Paclitaxel pharmacology
Palliative Care
Protein Processing, Post-Translational drug effects
Proto-Oncogene Proteins c-bcl-2 antagonists & inhibitors
Signal Transduction drug effects
Survival Analysis
Treatment Outcome
Tubulin metabolism
Adenocarcinoma drug therapy
Antineoplastic Agents, Phytogenic therapeutic use
Microtubules drug effects
Paclitaxel analogs & derivatives
Paclitaxel therapeutic use
Prostatic Neoplasms drug therapy
Taxoids
Subjects
Details
- Language :
- English
- ISSN :
- 0889-8588
- Volume :
- 15
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Hematology/oncology clinics of North America
- Publication Type :
- Academic Journal
- Accession number :
- 11525295
- Full Text :
- https://doi.org/10.1016/s0889-8588(05)70230-6