CLINICAL OVERVIEW OF THE TAXANES

Paclitaxel and docetaxel are taxane antineoplastic agents with broad a ntitumor activity. Since being introduced, they have become increasing ly important in the treatment of a number of major solid tumors. Pacli taxel plus a platinum analog is now considered first-line therapy for advanced ovarian cancer, and both paclitaxel and docetaxel have signif icant activity as single agents in recurrent ovarian cancer. Docetaxel may be useful in some of these women with ovarian cancer who fail or progress after paclitaxel-containing treatments. Both drugs have signi ficant response rates in the treatment of breast cancer and are option s for patients with advanced disease, including anthracycline-refracto ry disease. Administration of taxanes in new combination regimens and as adjuvant therapy for breast cancer is under investigation; for exam ple, the combination of paclitaxel and doxorubicin is highly active, a nd comparative studies of taxanes and anthracyclines should help clari fy optimal treatment regimens in breast cancer. Both drugs have signif icant activity alone in the treatment of advanced non-small cell lung cancer (NSCLC) and head and neck cancers. For the former, paclitaxel-c isplatin is now standard treatment in cooperative group combination th erapy trials. As a result of its radiosensitizing properties, paclitax el is undergoing extensive evaluation as combined modality treatment f or advanced NSCLC and head and neck cancer. Both taxanes will probably be useful in combination regimens in head and neck cancer. Research i s continuing to define further their roles and relative usefulness in other malignancies.