Paclitaxel
Vue déterministe de l'entité source de la LJAM. L'autorité clinique demeure avec les ID de la source cités et l'état d'approbation de l ́examinateur.
| ID | DRUG-PACLITAXEL |
|---|---|
| Type | Médicament |
| Alias | OnxolTaxolПаклітаксель |
| État | reviewed 2026-04-26 | pending_clinical_signoff |
| Maladies | DIS-ANAL-SCC DIS-BREAST DIS-CERVICAL DIS-ENDOMETRIAL DIS-ESOPHAGEAL DIS-GASTRIC DIS-GRANULOSA-CELL DIS-KAPOSI DIS-NSCLC DIS-OVARIAN DIS-PENILE-SCC DIS-SALIVARY DIS-TESTICULAR-GCT DIS-THYROID-ANAPLASTIC |
| Sources | SRC-ESMO-BREAST-EARLY-2024 SRC-NCCN-BREAST-2025 |
Faits sur les drogues
| Catégorie | Taxane (stabilisateur de microtubules) |
|---|---|
| Mécanisme | Diterpenoid originally isolated from Pacific yew (Taxus brevifolia). Binds the β-subunit of polymerized tubulin at the taxane-binding site, promoting microtubule assembly and stabilizing existing microtubules against depolymerization. Cells arrest at the G2/M-phase transition unable to complete mitosis, triggering apoptosis. Solubilized in Cremophor-EL (polyoxyethylated castor oil) + dehydrated alcohol — Cremophor-EL is responsible for the characteristic hypersensitivity reactions and necessitates premedication with corticosteroids + H1 + H2 antihistamines. |
| Dose typique | Breast (weekly, dose-dense and mCa schedules): 80 mg/m² IV over 1 h weekly. Breast (every-3-weeks): 175 mg/m² IV over 3 h q21d. Ovarian 1L (with carboplatin): 175 mg/m² IV over 3 h q21d × 6. Ovarian dose-dense (Japanese GOG): 80 mg/m² weekly × 18 wks with carboplatin AUC 6 q21d × 6. NSCLC (with carbo, Bevacizumab+CP): 200 mg/m² IV q21d × 4-6. CROSS (esophageal CRT): 50 mg/m² IV weekly × 5 with carboplatin AUC 2. Mandatory premedication: dexamethasone 20 mg PO at 12 h and 6 h before, OR 20 mg IV at 30 min before; diphenhydramine 50 mg IV + H2 blocker (ranitidine 50 mg IV or famotidine 20 mg IV) at 30 min before infusion. |
| Ukraine enregistrée | Vrai |
| NSZU remboursé | Vrai |
| Ukraine vérifiée pour la dernière fois | 2026-04-27 |
Avertissements
- Réactions d'hypersensibilité sévères (médiées par des crémophores; prémédication obligatoire)
- Myélosuppression sévère
Notes
Cross-disease entity. Standard of care in many regimens (weekly paclitaxel for breast adjuvant, dose-dense AC-T, KEYNOTE-522 phase 1 weekly carbo-paclitaxel for TNBC, carboplatin-paclitaxel for NSCLC + ovarian + gastric, CROSS for esophageal). Weekly dosing has improved DFS over q3w in node-positive breast (E1199 trial). Hypersensitivity management: stop infusion immediately at first sign (flushing, dyspnea, hypotension); IV steroids + antihistamines + epinephrine for severe; rechallenge possible after Grade 1-2 with enhanced premedication and slower infusion. Neuropathy: dose-reduce 20-25% for Grade 2 persistent; discontinue for Grade 3.
Utilisé par
Indication
IND-KAPOSI-2L-VISCERAL-PACLITAXEL- IND-KAPOSI-2L-VISCERAL-PACLITAXEL
Protocole thérapeutique
REG-CARBO-PACLI-ANAL-MET- Carboplatin + paclitaxel (anal carcinoma, metastatic)REG-CARBO-PACLI-CONCURRENT-RT-ESOPH- Weekly carboplatin + paclitaxel concurrent with definitive RT (esophageal)REG-CARBO-PACLI-OVARIAN- Carboplatin + Paclitaxel (ovarian 3-weekly)REG-CARBOPLATIN-PACLITAXEL-GCT- Carboplatin + Paclitaxel (adult granulosa cell tumor, advanced/recurrent)REG-CARBOPLATIN-PACLITAXEL-WEEKLY- Weekly carboplatin + paclitaxel (CROSS-style chemo backbone)REG-DOSTARLIMAB-CARBO-PACLI-ENDOM- Dostarlimab + carbo + paclitaxel (MMR 1L avancé endométrial)REG-NIVO-IPI-CHEMO-NSCLC-1L- Nivolumab + Ipilimumab + 2-Cycles de chimiothérapie à double platine (CheckMate-9LA)REG-PACLITAXEL-CARBOPLATIN-ATC- Paclitaxel + carboplatin (ATC, palliative 1L)REG-PACLITAXEL-CARBOPLATIN-SALIVARY- Paclitaxel + carboplatin (salivary gland carcinoma, palliative)REG-PACLITAXEL-KAPOSI- Paclitaxel en monothérapie (sarcome de Kaposi, post-anthracycline)REG-PACLITAXEL-RAMUCIRUMAB-GASTRIC- Paclitaxel + Ramucirumab (RAINBOW) - 2L gastrique/GEJREG-PEMBRO-CARBO-PACLI-ENDOM- Pembrolizumab + carbo + paclitaxel (endométrie avancée 1L)REG-PEMBRO-CARBO-PACLITAXEL-NSCLC-SQ- Pembrolizumab + carboplatin + paclitaxel (squamous NSCLC, first line)REG-PEMBRO-CHEMO-TNBC-MET- Pembrolizumab + chimiothérapie (TNBC, PD-L1+ métastatique)REG-PEMBRO-CHEMO-TNBC-NEOADJUVANT- Pembrolizumab + chimio (TNBC néoadjuvant)REG-PEMBRO-PACLI-CARBO-BEV-CERVICAL- Pembrolizumab + paclitaxel + carboplatin ± bevacizumab (cancer du col de l'utérus, 1L)REG-PEMBROLIZUMAB-CERVICAL-1L- Pembrolizumab + carboplatin + paclitaxel ± bevacizumab (persistant/récurrent/métastatique c...REG-RETIFANLIMAB-CARBO-PACLI-ANAL-1L- Retifanlimab + carboplatin + paclitaxel (advanced anal SCC 1L, POD1UM-303)REG-TIP-GCT-SALVAGE- TIP (paclitaxel + ifosfamide + cisplatin, germ cell tumor salvage)REG-TIP-PENILE- TIP (paclitaxel + ifosfamide + cisplatin, penile SCC)REG-WEEKLY-PAC-BEV-OVARIAN- Paclitaxel + Bevacizumab hebdomadaire (ovaire récurrent résistant au platine, AURELIA)