Paclitaxel

Paclitaxel (Taxol) is a type of taxane chemotherapy. Paclitaxel is made from the bark of the Pacific yew tree. It is used to treat breast cancer as well as many other types of cancer.

How paclitaxel works

Paclitaxel works by damaging the microtubules, the “skeleton”, that support cancer cells. This stops the cancer cells from dividing normally, and results in the death of the cancer cells.

Who gets paclitaxel

Paclitaxel may be used as a part of chemotherapy treatment regimens for most types of invasive breast cancer, including triple-negative breast cancer, to lower the risk of the breast cancer coming back after surgery. It can also be used with targeted therapy, such as trastuzumab (Herceptin), to treat HER2-positive breast cancers.

Sometimes paclitaxel is given alone as a treatment in metastatic breast cancer.

How paclitaxel is given

Paclitaxel is usually given as part of a regimen with other chemotherapy medicines in early-stage breast cancers that require chemotherapy. A common combination in breast cancer is AC-T (Adriamycin and Cytoxan, followed by Taxol). It can also be given with other chemotherapy medicines like carboplatin (Paraplatin), or with monoclonal antibodies like trastuzumab (Herceptin).

Paclitaxel is given by vein. It is usually given in several cycles, with a treatment given on one day, followed by a period of “off” days. The exact schedule depends on the regimen and dose used. It is often given weekly, every 2 weeks, or every 3 weeks.

It can be given as part of neoadjuvant (before surgery) treatment or as part of adjuvant (after surgery) treatment. An entire course of chemotherapy for breast cancer usually takes from 3 to 6 months.

In some cases your doctor may recommend a dose-dense schedule, which means medicines are given with less time between treatments than in a standard chemotherapy treatment plan. For example, a common treatment regimen is dose-dense doxorubicin (Adriamycin) and cyclophosphamide (Cytoxan) every 2 weeks for four cycles followed by paclitaxel (Taxol) every 2 weeks for four cycles.

For metastatic breast cancer, paclitaxel is usually given weekly in low doses, to limit side effects. It can also be given every 3 weeks.

Side effects and things to remember

Before starting paclitaxel, tell your doctor about any medicines you are taking, including vitamins, herbal supplements, and over-the-counter medicines, as well as any existing or previous health problems.

Paclitaxel can cause an allergic reaction, and so can another ingredient given with it, called Cremophor. Your doctor may give you medicine to prevent the reaction on the day that you get treatment.

Be sure to get emergency medical help if you have any signs of an allergic reaction, such as:

• hives or red skin rash
• difficulty breathing
• faintness
• swelling of your face, lips, tongue, or throat

Other side effects of paclitaxel may include:

• Diarrhea
• Hair loss
• Menopausal symptoms
• Mouth sores
• Neuropathy (numbness or tingling in the hands and feet)
• Neutropenia (low level of a type of white blood cell)
• Vomiting
• Weakness and fatigue
• Bone pain or muscle pain
• Rash

Paclitaxel can temporarily affect how your body makes blood cells, which can decrease your blood cell counts. This is called bone marrow suppression. Your doctors will test your blood counts regularly. The blood cell count changes can include a decrease in:

• Red blood cells, which carry oxygen in your body to help give you energy
• White blood cells, which fight infection in your body
• Platelets, which help clot the blood to stop bleeding

Talk to your doctor, pharmacist or nurse about all your side effects so that they can help you manage them. You can also go to our section on Side Effects for more information.