Role of TDM-based dose adjustments for taxane anticancer drugs

Br J Clin Pharmacol. 2021 Feb;87(2):306-316. doi: 10.1111/bcp.14678. Epub 2020 Dec 18.

Abstract

The classical taxanes (paclitaxel, docetaxel), the newer taxane cabazitaxel and the nanoparticle-bound nab-paclitaxel are among the most widely used anticancer drugs. Still, the optimal use and the value of pharmacological personalization of the taxanes is still controversial. We give an overview on the pharmacological properties of the taxanes, including metabolism, pharmacokinetics-pharmacodynamic relations and aspects in the clinical use of taxanes. The latter includes the ongoing debate on the most effective and safe regimen, the recommended initial dose, and pharmacological dosing individualization. The taxanes are among the most widely used anticancer drugs in patients with solid malignancies. Despite their longtime use in clinical routine, the optimal dosing strategy (weekly versus 3-weekly) or optimal average dose (cabazitaxel, nab-paclitaxel) has not been fully resolved, as it may differ according to tumour entity and line of treatment. The value of pharmacological individualization of the taxanes (TDM, TCI) has been partly explored for 3-weekly paclitaxel and docetaxel, but remains mostly unexplored for cabazitaxel and nab-paclitaxel at present.

Keywords: chemotherapy; clinical pharmacology; pharmacotherapy; therapeutic drug monitoring; toxicology.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents*
  • Breast Neoplasms*
  • Bridged-Ring Compounds
  • Docetaxel
  • Female
  • Humans
  • Paclitaxel
  • Taxoids

Substances

  • Antineoplastic Agents
  • Bridged-Ring Compounds
  • Taxoids
  • Docetaxel
  • taxane
  • Paclitaxel