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Taxotere vs. Taxol in the Treatment of Cancer of the Pancreas

written by: ellaalle • edited by: Diana Cooper • updated: 4/28/2011

The risks of Taxol and Taxotere are based on the health of the patient. Most patients have limited side effects below the maximum tolerated dose. The benefits include increased survival time and slower disease progression.

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    Introduction

    Cancer of the pancreas is treatable through pharmaceutics such as Taxotere (docetaxel) or Taxol (paclitaxel). Both products are available in generic form in the United States. The FDA allows these entities for treatment of pancreatic and other cancers, while recognizing pancreatic cancer often does not adequately respond to treatment efforts. Each pharmaceutical is currently in clinical trials.

    When compared side-by-side, taxotere vs taxol in pancreas cancer have similar benefits and drawbacks, as they are both anti-mitotic therapies. This means they prevent cell division and growth. Taxotere and taxol are usually considered when the treatment Gemcitabine fails. However, they do have minor differences such as dosing and treatment combinations.

    As of 2011, both are administered by intravenous drip. Research for other delivery methods is ongoing.

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    Taxotere

    Taxotere uses a weekly dosing regimen with 25 mg per meter squared, or 75 mg per meter squared every three weeks. The journal Anticancer Research published a 2010 study titled “Docetaxel Second-line Therapy in Patients with Advanced Pancreatic Cancer: A Retrospective Study". This therapy had remission in 6 percent of patients. No severe toxicity such as low thrombocytes occurred in this study.

    Dosing ranges are experimental and are varied based on the severity of the cancer. A Japanese study (Okada et al) published in the British Journal of Medicine used 60 mg/m2 with a 1-2 hour dose administration. This study had more participants and had no objective positive effect. Contrary to the Anticancer Research paper, this study had widespread toxicity and one patient death specifically due to treatment. The trial determined the maximum tolerable dose is 70-90 mg/m2.

    It is important to note that docetaxel is rarely effective as a monotherapy. Adjuvants for docetaxel improve efficacy. Regimens include docetaxel and: gemcitabine, 5-fluorouracil, thalidomide or irinotecan. Radiation treatment plus docetaxel is a common therapy.

    The median survival time after diagnosis of pancreatic cancer is six months. The treatment combination of GTX (gemcitabine, docetaxel, capecitabine) had a better survival rate of 11.2 months.

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    Taxol

    Taxol (paclitaxel) is another experimental therapy, sometimes delivered in oral liposomal form. The core drug is surrounded with a fat layer to prevent degradation. As of 2009, this is now considered an orphan drug by the EU.

    In the United States, Taxol is injected with gemcitabine weekly. The paclitaxel dose is 80 mg/m2. The disease was well-controlled, but the median survival time was 101 days. This is similar to untreated controls. All subjects had extremely late-term disease, however.

    Another formulation is nab-paclitaxel, or nanoparticle albumin-bound paclitaxel. A 2008 Phase I trial in the Journal of Clinical Oncology (Drengler et al) in combination with gemcitabine showed preliminary safety. A 2010 study showed 58 percent of patients had a six month survival rate with nab-paclitaxel monotherapy. The dose was 100 mg/m2 weekly.

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    Conclusion

    Both Taxotere and Taxol are experimental therapies. Since they are second-line therapies, researchers and physicians use personal preference and lab work to determine the recommended protocol. Treatment considerations should be in consultation with a physician.

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    References

    "Data Evaluating Use of Nab-paclitaxel for Treatment of Pancreatic Cancer to Be Presented at ASCO 2010." THE MEDICAL NEWS | from News-Medical.Net - Latest Medical News and Research from Around the World. Web. 26 Apr. 2011. <http://www.news-medical.net/news/20100521/Data-evaluating-use-of-nab-paclitaxel-for-treatment-of-pancreatic-cancer-to-be-presented-at-ASCO-2010.aspx>.

    "Docetaxel Chemotherapy for Pancreatic Cancer: Do Results Support Certainty?" Journal of Clinical Oncology. Web. 26 Apr. 2011. <http://jco.ascopubs.org/content/18/2/445.full>

    Fine et al. “The gemcitabine, docetaxel, and capecitabine (GTX) regimen for metastatic pancreatic cancer: a retrospective analysis" CANCER CHEMOTHERAPY AND PHARMACOLOGY Volume 61, Number 1, 167-175

    Shukuya, et al. “Weekly Paclitaxel after failure of gemcitabine in pancreatic cancer patients with malignant ascites: a retrospective study." Jpn J Clin Oncol. 2010 Dec;40(12):1135-8. Epub 2010 Jul 22.

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