One-hour paclitaxel infusions: Review of safety and efficacy

PURPOSE Paclitaxel has emerged as one of the most active anticancer agents in clini cal oncology. Hypersensitivity reactions encountered in the clinical develo pment of this drug prompted the implementation of premedication regimens an d prolonged infusions, later amended to a 3-hour infusion schedule. Now tha t paclitaxel is frequently used in outpatient therapy, optimum efficiency i n delivery is an issue. A 1-hour drug infusion is more efficient for both t he patient and the clinic staff and can help reduce administration costs. T his article reviews the current experience with 1-hour paclitaxel infusions . METHODS Published studies using 1-hour paclitaxel infusions, including weekly studi es, trials of combination chemotherapy, and combined-modality studies, were reviewed. Studies were evaluated for both efficacy and toxicity. RESULTS AND CONCLUSIONS Paclitaxel administered by 1-hour infusion as part of weekly or every-3-wee k treatment regimens is active in a variety of tumors, including breast, ov arian, and lung cancer and carcinoma of unknown primary site. Leukopenia, t he most common serious toxicity, is usually manageable without hematopoieti c growth factor support. The frequency of neurotoxicity appears comparable for 1-hour and 3-hour regimens, and there is no increased risk of hypersens itivity reactions. Infusion duration has been suggested to be an important predictor of response in some tumor types. Evaluation of this issue using a 1-hour paclitaxel infusion as reference is reasonable. One-hour infusions of paclitaxel should simplify outpatient administration, reduce administrat ion costs, and reduce clinic time for patients. Practical information regar ding administration of paclitaxel by 1-hour infusion is provided.