II. Indications
- FDA Approved (often combined with other agents)
- Breast Cancer
- Gastric Cancer
- Head and Neck Cancer (Squamous Cell Carcinoma)
- Non-Small Cell Lung Cancer
- Prostate Cancer (metastatic, Hormone-refractory)
- Off-Label
- Melanoma
- Non-Hodgkin's Lymphoma
- Ovarian Cancer
- Pancreatic Cancer
- Sarcoma (soft tissue)
- Small Cell Lung Cancer
- Urothelial Cancer
III. Mechanism
- See Mitotic Inhibitor Chemotherapy
- Docetaxel is a semi-synthetic, second-generation Taxane
- Derived from extract of the European yew tree (Taxus baccata)
- Docetaxel has antineoplastic activity (Taxane)
- Binds and stabilizes tubulin
- Inhibits microtubule disassembly
- Results in Cell Cycle arrest in G2/M phase
- Docetaxel inhibits proangiogenic factors (new vessel formation promotors)
- Inhibits Vascular Endothelial Growth Factor (VEGF)
- Docetaxel induces inflammatory response
- Stimulates inflammatory mediators
IV. Medications
- Available in both IV and IV concentrate solutions: 20 mg to 200 mg vials
V. Dosing
- See other references for disease specific dosing protocols
VI. Adverse Effects
- Edema
- Fatigue
- Hepatotoxicity
-
Hypersensitivity Reaction (severe)
- Subsequent reactions after an initial may grow in severity
- Cross reacts with Paclitaxel Hypersensitivity
- Impaired future fertility
- Intoxication (Alcohol related)
- Myelosuppression (Bone Marrow Suppression)
- Neutropenia (severe)
-
Peripheral Neuropathy
- Less than Paclitaxel
- Paresthesias
- Skin Changes
- Extremity erythema
- Nail pigmentation changes
- Alopecia (may be irreversible)
VII. Safety
- Avoid in Lactation
- Avoid in pregnancy (all trimesters)
- Use reliable Contraception
- Monitoring
VIII. Drug Interactions
-
CYP3A4 Inhibitors or substrates
- Increases Docetaxel serum concentrations
IX. Resources
- Docetaxel Injection Solution (DailyMed)