Clinical trials and progress with paclitaxel in ovarian cancer

Sanjeev Kumar¹, Haider Mahdi², Christopher Bryant¹, Jay P Shah¹, Gunjal Garg³, Adnan Munkarah^4
1Department of Obstetrics and Gynecology, Wayne State University School of Medicine and Karmanos Cancer Institute Detroit, Michigan; ²Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington; ³Department of Obstetrics and Gynecology, University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan; ⁴Department of Obstetrics and Gynecology, Henry Ford Hospital, Detroit, Michigan, USA

Abstract: Paclitaxel is a front-line agent for ovarian cancer chemotherapy, along with the platinum agents. Derived from the Pacific yew tree, Taxus brevifolia, paclitaxel has covered significant ground from the initial discovery of its antineoplastic properties to clinical applications in many forms of human cancers, including ovarian cancer. Although much has been published about the unique mechanism of action of this agent, several issues remain to be resolved. Finding the appropriate dosage schedule for paclitaxel in chemo-naïve and recurrent ovarian cancer, defining the role of paclitaxel in maintenance chemotherapy, and elucidating the mechanisms of taxane resistance are areas of intense research. Newer forms of taxanes are being manufactured to avoid troublesome adverse effects and to improve clinical efficacy. These issues are reviewed in detail in this paper with an emphasis on clinically relevant evidence-based information.

Keywords: paclitaxel, clinical trials, ovarian cancer, treatment