II. Indications

  1. FDA Approved (often combined with other agents)
    1. Breast Cancer
    2. Gastric Cancer
    3. Head and Neck Cancer (Squamous Cell Carcinoma)
    4. Non-Small Cell Lung Cancer
    5. Prostate Cancer (metastatic, Hormone-refractory)
  2. Off-Label
    1. Melanoma
    2. Non-Hodgkin's Lymphoma
    3. Ovarian Cancer
    4. Pancreatic Cancer
    5. Sarcoma (soft tissue)
    6. Small Cell Lung Cancer
    7. Urothelial Cancer

III. Mechanism

  1. See Mitotic Inhibitor Chemotherapy
  2. Docetaxel is a semi-synthetic, second-generation Taxane
    1. Derived from extract of the European yew tree (Taxus baccata)
  3. Docetaxel has antineoplastic activity (Taxane)
    1. Binds and stabilizes tubulin
    2. Inhibits microtubule disassembly
    3. Results in cell cycle arrest in G2/M phase
  4. Docetaxel inhibits proangiogenic factors (new vessel formation promotors)
    1. Inhibits Vascular Endothelial Growth Factor (VEGF)
  5. Docetaxel induces inflammatory response
    1. Stimulates inflammatory mediators

IV. Medications

  1. Available in both IV and IV concentrate solutions: 20 mg to 200 mg vials

V. Dosing

  1. See other references for disease specific dosing protocols

VI. Adverse Effects

  1. Edema
  2. Fatigue
  3. Hepatotoxicity
  4. Hypersensitivity Reaction (severe)
    1. Subsequent reactions after an initial may grow in severity
    2. Cross reacts with Paclitaxel Hypersensitivity
  5. Impaired future fertility
  6. Intoxication (Alcohol related)
  7. Myelosuppression (Bone Marrow Suppression)
    1. Neutropenia (severe)
  8. Peripheral Neuropathy
    1. Less than Paclitaxel
    2. Paresthesias
  9. Skin Changes
    1. Extremity erythema
    2. Nail pigmentation changes
    3. Alopecia (may be irreversible)

VII. Safety

  1. Avoid in Lactation
  2. Avoid in pregnancy (all trimesters)
    1. Use reliable Contraception
  3. Monitoring
    1. Complete Blood Count
    2. Liver Function Tests

VIII. Drug Interactions

  1. CYP3A4 Inhibitors or substrates
    1. Increases Docetaxel serum concentrations

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