Head cancers paclitaxel

Investigators have taken several different approaches to the integration of paclitaxel into radical therapy in head and neck cancer. Rosenthal et al. undertook a multicenter... 

The common link with many clinical studies of chemoradiation in head and neck cancers is the significant mucositis that patients experience during therapy. Acrein has reported on a trial that attempts to deliver Ethyol as a protective agent to lessen the side effects of weekly paclitaxel (134). 

Dowell JE, Sinard R, Yardley DA, et al. Seven-week continuous-infusion paclitaxel concurrent with radiation therapy for locally advanced non-small cell lung and head and neck cancers. Semin Radiat Oncol 1999 9(2 Suppl 1) 97-101. 

Sunwoo JB, Herscher LL, Kroog GS, et al. Concurrent paclitaxel and radiation in the treatment of locally advanced head and neck cancer. J Clin Oncol 2001 19(3) 800-811. 

Machtay M, Aviles V, Kligerman MM, et al. A phase I trial of 96-hour paclitaxel infusion plus accelerated radiotherapy of unresectable head and neck cancer. Int J Radiat Oncol Biol Phys 1999 44(2) 311-315. 

Kies ME, Haraf D, Rosen F, Stenson K, List M, Brockstein B, Chung T, Mittal B, Pelzer H, Portugal L, Rademaker A, Weichselbaum R, Vokes EE. Concomitant Infusional Paclitaxel and Fluorouracil, Oral Hydroxyurea, and Hyperfractionated Radiation for Locally Advanced Squamous Head and Neck Cancer. J Clin Oncol 2001 19 1961-1969. 

Leonard CE, Chan DC, Chou TC, et al. Paclitaxel enhances in vitro radiosensitivity of squamous carcinoma cell lines of the head and neck. Cancer Res 1996 56 5198-5204. 

Forastiere AA, Shank D, Neuberg D, et al. Final report of a phase II evaluation of paclitaxel in patients with advanced squamous cell carcinoma of the head and neck an Eastern Cooperative Oncology Group trial (PA390). Cancer 1998 82 2270-2274. 

Hoffmann W, Belka C, Schmidberger H, et al. Radiotherapy and concomitant weekly 1-hour infusion of paclitaxel in the treatment of head and neck cancer—results from a Phase I trial. Int J Radiat Oncol Biol Phys 1997 38 691-696. 

BrocksteinB, Haraf DJ, Stenson K, etal. Phase I study of concomitant chemoradio therapy with paclitaxel, fluorouracil, and hydroxyurea with granulocyte colony-stimulating factor support for patients with poor-prognosis cancer of the head and neck. J Clin Oncol 1998 16 735-744. 

Murphy B, Li Y, Celia D, et al. Phase III study comparing cisplatin (C) and 5-Fluorouracil (F) versus cisplatin and paclitaxel (T) in metastatic/recurrent head and neck cancer (MHNC). ProcAnnu Meet Am Soc Clin Oncol 2001 20 A894. 

Nielsen LL, Lipari P, Dell J, Gurnani M, Hajian G. Adenovirus-mediated p53 gene therapy and paclitaxel have synergistic efficacy in models of human head and neck. Clin Cancer Res 1998 4 835-846. 

Paclitaxel is among the most active of all anticancer drugs, with significant efficacy against carcinomas of the breast, ovary, lung, head, and neck. It is combined with cisplatin in the therapy of ovarian and lung carcinomas and with doxorubicin in treating breast cancer. 

Paclitaxel Inhibits mitosis Breast cancer, non-small cell and small cell lung cancer, ovarian cancer, gastroesophageal cancer, prostate cancer, bladder cancer, head and neck cancer Nausea, vomiting, hypotension, arrhythmias, hypersensitivity Myelosuppression, peripheral sensory neuropathy... 

Docetaxel is a semisynthetic taxane derived from the European yew tree. Its mechanism of action, metabolism, and elimination are identical to those of paclitaxel. It is approved for use as second-line therapy in advanced breast cancer and non-small cell lung cancer, and it also has major activity in head and neck cancer, small cell lung cancer, gastric cancer, advanced platinum-refractory ovarian cancer, and bladder cancer. Its major toxicities are listed in Table 54-4. 

Originally developed as part of a large-scale effort headed by the United States National Cancer Institute to investigate chemotherapeutic agents from natural sources, paclitaxel was approved by the FDA in 1992 as an antineoplastic agent to treat metastatic ovarian cancer after failure of first-line or subsequent chemotherapy (37). Further studies demonstrated efficacy in other solid tumors (38). In addition, paclitaxel was shown to inhibit T- and B-cell proliferation when tested for transplant-rejection application (39,40) and has demonstrated inhibition of matrix-metalloproteinase synthesis in studies conducted to test its utility for rheumatoid arthritis (41). 

Paclitaxel (Taxol) -Ovarian cancer breast cancer KS NSCLC SCLC esophageal and head and neck cancers testicular cancer bladder cancer cervical and endometrial cancers... 

The first compound of the taxanes series, paclitaxel (Taxol), was isolated from the bark of the Western yew tree in 1971. It and its congenic, the semisynthetic docetaxel (Taxotere), exhibit unique pharmacological actions as inhibitors of mitosis, differing from the vinca alkaloids and colchicine derivatives in that they bind to a different site on P-tubulin and promote rather than inhibit microtubule formation. The drugs have a central role in the therapy of ovarian, breast, lung, esophageal, bladder, and head and neck cancers. 

Cisplatin, in combination with bleomycin, etoposide, ifosfamide, or vinblastine, cures 90% of patients with testicular cancer. Used with paclitaxel, cisplatin induces complete response in most patients with carcinoma of the ovary. Cisplatin produces responses in cancers of the bladder, head and neck, cervix, and endometrium all forms of carcinoma of the lung anal and rectal carcinomas and neoplasms of childhood. The drug sensitizes cells to radiation therapy and enhances control of locally advanced lung, esophageal, and head and neck tumors when given with irradiation. 

Grecula, J.C., Smith, R.E., Rhoades, C.A., Sharma, P, Agarwal, A., Zheang, H., AUen, J., Goldman, F.P., Young, D., and Schuller, D.E., Induction paclitaxel in previously untreated, resectable, advanced squamous cell carcinomas of head and neck a phase II trial. Cancer, 89, 2587,2000. 

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