Neutropenia docetaxel

Docetaxel Neutropenia (DLT), hyperlacrimation, fluid retention, nail disorders, myelosuppression Use with caution in liver dysfunction. Do not give if biliary tract is obstructed. Premedicate dexamethasone. 

Docetaxel Inhibits mitosis Breast cancer, non-small cell lung cancer, prostate cancer, gastric cancer, head and neck cancer, ovarian cancer, bladder cancer Hypersensitivity Neurotoxicity, fluid retention, myelosuppression with neutropenia... 

Generic Name Docetaxel Trade Name Taxotere Primary Antineoplastic Indication(s) Breast cancer Common Adverse Effects Blood disorders (anemia, leukopenia, neutropenia] fever fluid retention paresthesias/dysthesias skin rash-es/itching stomatitis Gl distress (nausea, diarrhea] ... 

Docetaxel 100 mg/m2 IV over 1 hour every 3 weeks Hypersensitivity, rash Neurotoxicity, fluid retention, neutropenia... 

Haematological parameters. Full blood count must be analysed prior to administration of trastuzumab/docetaxel chemotherapy to check for persistent bone marrow suppression. Low neutrophil or platelet counts (typically neutrophils <1.5 x 109/L or platelets <100 x 109/L) will necessitate a delay in docetaxel administration, usually by one week (although trastuzumab could be continued as bone marrow suppression is not considered to be a contraindication to treatment with this agent). The occurrence of febrile neutropenia between treatment cycles may also necessitate dose reduction of docetaxel. 

DOCETAXEL TOPOTECAN t risk of neutropenia when topotecan is administered on days 1-4 and docetaxel on day 4 Attributed to 1 clearance of docetaxel (by 50%) due to inhibition of hepatic metabolism of docetaxel by CYP3A4 by topotecan Administer docetaxel on day 1 and topotecan on days 1-4... 

DOCETAXEL VINORELBINE Administration of docetaxel after vinorelbine t plasma concentrations ofvinorelbine, along with t risk of neutropenia compared with giving docetaxel first Docetaxel likely causes 1 clearance ofvinorelbine Administer docetaxel first and follow it with vinorelbine... 

Topotecan reduced docetaxel clearance by 50% and increased the severity of neutropenia when given over three consecutive days before the combination (155). The underlying reason for this interaction has not been elucidated however, when combination therapy is used, docetaxel should be scheduled on day 1 and topotecan on days 1. ... 

Toxicity Paclitaxel causes neutropenia, thrombocytopenia, a high incidence of peripheral neuropathy, and possible hypersensitivity reactions during infusion. Docetaxel causes neurotoxicity and bone marrow depression. 

In a study, 627 patients with breast cancer were given either doxorubicin 50 mg/m with docetaxel 75 mg/m, or doxorubicin 60 mg/m with cyclophosphamide 600 mg/m postoperatively for 4 courses to assess disease-free survival at 5 years. The study was terminated prematurely because of the high risk of life-threatening complications in those given doxorubicin with docetaxel (2 deaths associated with drug toxicity and one case of perforated peritonitis in patients with febrile neutropenia). The incidence of febrile neutropenia was 40.8% and 7.1% in the doxorubicin-docetaxel and doxorubicin-cyclophosphamide groups, respectively. ... 

Uchiyama T, Kanno H, Ishitani K, Fujii H, Ohta H, Matsui H, Kamatani N, Saito K (2012) An SNP in CYP39A1 is associated with severe neutropenia induced by docetaxel. Cancer Chemother Pharmacol 69 1617 1624... 

Docetaxel Taxane (Diterpene) Breast, prostate, ovarian, nonsmall cell lung Inhibition mitotic cell-division Acral erythema scleroderma-Uke Neutropenia anemia Dys Br GI symptoms Cross-reaction with paclit el but reactions less frequent Infusion... 

Drug-drug iuteractious Docetaxel Cele-coxib may enhance the marrow toxicity of docetaxel [50 ]. In patients (24 enrolled, 20 treated) with non-small cell lung cancers celecoxib 400 mg orally bd was started 7 days before the first cycle of docetaxel and continued without interruption. Docetaxel 75 mg/ m was administered intravenously on a 21-day cycle. Frequent neutropenia (14 patients, 58%) and neutropenic fever (5 patients, 21%) resulted in early closure of the trial. 

Hematologic Neutropenia was the dose-limiting adverse reaction in most phase I and phase II studies of docetaxel, with a median duration to nadir counts of 7 days [132 ]. This appears to be dose-related, but not schedule-related (unlike paclitaxel). In a large phase III trial, 9.6% of patients receiving 3-weekly docetaxel 75 mg/m developed grade 3/4 neutropenia [112 ]. 

Cousin S, Le Rhun E, Maflliez A, Fournier C, Bonneterre J. Febrile neutropenia incidence and hematological toxicity with the FECIOO-docetaxel regimen in the treatment of early-stage breast cancer. Bvill Cancer 2012 99(7-8) 75-80. 

A-II, were identified. Protein expression profiles determined by MS are thus useful for idenfilying treatment-responsive proteins [25], Toxicity can be severe in case of chemotherapy. MS-based techniques may also be applied to reduce side effects. A study evaluated the association between exposure to unbound docetaxel and neutropenia in cancer patients and identified factors influencing unbound docetaxel clearance. Pharmacokinetic studies and toxicity assessments were performed during the first cycle of therapy. Total docetaxel concentrations were determined by HPLC-MS-MS. The authors conclude that as exposure to unbound docetaxel is closely related to drug-induced hematologic toxicity, this needs to be considered in future pharmacological investigations [26]. 

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