Docetaxel

Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.

ID	`DRUG-DOCETAXEL`
Тип	Препарат
Синоніми	DocefrezDocetereTaxotereДоцетаксель
Статус	переглянуто 2026-04-26 \| очікує клінічного підпису
Хвороби	`DIS-BREAST` `DIS-CRC` `DIS-ESOPHAGEAL` `DIS-GASTRIC` `DIS-NSCLC` `DIS-PROSTATE` `DIS-SOFT-TISSUE-SARCOMA`
Джерела	`SRC-ESMO-PROSTATE-2024` `SRC-NCCN-PROSTATE-2025`

Дані про препарат

Клас	Taxane (microtubule stabilizer)
Механізм дії	Semi-synthetic taxane derived from European yew (Taxus baccata). Binds the β-subunit of polymerized tubulin at the taxane-binding site (~1.9× higher affinity than paclitaxel), promoting microtubule assembly and stabilizing existing microtubules against depolymerization. Cells arrest at G2/M, triggering apoptosis. Solubilized in polysorbate 80 (Tween 80) + ethanol — premedication with corticosteroids critical to prevent fluid retention and hypersensitivity (Cremophor-EL not used in docetaxel). Higher myelosuppression and febrile neutropenia rates than paclitaxel.
Типове дозування	Prostate (mHSPC + mCRPC): 75 mg/m² IV q3 weeks × 6 cycles (mHSPC, CHAARTED) or × 10 cycles (mCRPC, TAX-327, until intolerance). Breast adjuvant TAC: 75 mg/m² IV day 1 q21d × 6 (with doxorubicin 50 mg/m² + cyclophosphamide 500 mg/m²). Breast metastatic mono: 60-100 mg/m² IV q21d. NSCLC 2L mono: 75 mg/m² IV q21d. NSCLC 1L (with cisplatin): 75 mg/m² IV q21d. Gastric DCF: 75 mg/m² IV day 1 q21d (with cisplatin + 5-FU). Head and neck TPF induction: 75 mg/m² IV day 1 q21d × 3 (with cisplatin + 5-FU). Mandatory premedication: dexamethasone 8 mg PO BID × 3 days starting day before infusion (to prevent fluid retention and hypersensitivity).
Зареєстровано в Україні	True
Відшкодовується НСЗУ	True
Остання перевірка для України	2026-04-27

Застереження

Hepatic dysfunction — increased risk of severe / fatal toxicity (avoid if bilirubin > ULN)
Severe neutropenia — neutropenic deaths reported
Severe hypersensitivity reactions
Severe fluid retention (premedication mandatory; can be fatal)

Нотатки

Cytotoxic backbone added to ADT for high-volume mHSPC (CHAARTED, STAMPEDE) and as ARASENS triplet partner with darolutamide. mCRPC option (TAX-327) but ARPIs typically preferred 1L if no high-volume burden. Hepatic adjustment essential — bilirubin > ULN requires dose reduction or avoidance. Premedication: dexamethasone 8 mg PO BID × 3 days starting day before to prevent fluid retention + hypersensitivity. G-CSF primary prophylaxis for high febrile- neutropenia risk regimens (TAC, TPF, DCF). Cumulative neuropathy + nail toxicity may be dose-limiting after several cycles.

Де використовується

Regimens

REG-ADT-DAROLUTAMIDE-DOCETAXEL - ADT + darolutamide + docetaxel (ARASENS triplet)
REG-DOCETAXEL-MCRPC - Docetaxel (mCRPC)
REG-DOCETAXEL-RAMUCIRUMAB - Docetaxel + Ramucirumab (REVEL) — 2L+ NSCLC post-platinum / post-ICI
REG-FLOT - FLOT
REG-GEMCITABINE-DOCETAXEL-STS - Gemcitabine + docetaxel (soft tissue sarcoma)
REG-TCHP-NEOADJUVANT - TCHP — docetaxel + carboplatin + trastuzumab + pertuzumab (HER2+ neoadjuvant)
REG-THP-METASTATIC - THP — docetaxel + trastuzumab + pertuzumab (HER2+ metastatic 1L)