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Paclitaxel

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDDRUG-PACLITAXEL
TypeDrug
Aliases
OnxolTaxolПаклітаксель
Statusreviewed 2026-04-26 | pending_clinical_signoff
DiseasesDIS-ANAL-SCC DIS-BREAST DIS-CERVICAL DIS-ENDOMETRIAL DIS-ESOPHAGEAL DIS-GASTRIC DIS-GRANULOSA-CELL DIS-NSCLC DIS-OVARIAN DIS-SALIVARY DIS-TESTICULAR-GCT DIS-THYROID-ANAPLASTIC
SourcesSRC-ESMO-BREAST-EARLY-2024 SRC-NCCN-BREAST-2025

Drug Facts

ClassTaxane (microtubule stabilizer)
MechanismDiterpenoid 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.
Typical dosingBreast (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 registeredTrue
NSZU reimbursedTrue
Ukraine last verified2026-04-27

Warnings

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.

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