Micellar paclitaxel in the treatment of patients with tumors of the female reproductive system

Background. Treatment of patients with advanced cancers of the female reproductive system is very challenging. The most common treatment scheme for such patients includes paclitaxel 135—175 mg/m2 + carboplatin AUC 5—6 or cisplatin 75 mg/m2. However, lengthy treatment with this regimen is limited by...

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Main Authors: A. G. Kedrova, S. E. Krasilnikov, D. A. Astakhov, V. V. Kosyy
Format: Article
Language:Russian
Published: ABV-press 2019-11-01
Series:Опухоли женской репродуктивной системы
Subjects:
Online Access:https://ojrs.abvpress.ru/ojrs/article/view/661
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author A. G. Kedrova
S. E. Krasilnikov
D. A. Astakhov
V. V. Kosyy
author_facet A. G. Kedrova
S. E. Krasilnikov
D. A. Astakhov
V. V. Kosyy
author_sort A. G. Kedrova
collection DOAJ
description Background. Treatment of patients with advanced cancers of the female reproductive system is very challenging. The most common treatment scheme for such patients includes paclitaxel 135—175 mg/m2 + carboplatin AUC 5—6 or cisplatin 75 mg/m2. However, lengthy treatment with this regimen is limited by adverse events, such as neuropathy, allergic reactions, nephropathy, etc. The new micellar form of paclitaxel has demonstrated better tolerability compared to conventional paclitaxel and, considering the increased safe effective dose (up to 250 mg/m2) it should ensure higher efficacy and better progression-free survival. The use of cremophor EL free paclitaxel is recommended in patients with concomitant extragenital diseases (including diabetes and neurological deficit), in elderly patients, and in patients with allergic reactions, as well as in cases when additional steroids should be avoided.Objective: to summarize the experience of using the new form of paclitaxel in patients with tumors of the female reproductive system and concomitant diseases.Materials and methods. We analyzed both world and our own experience in using micellar paclitaxel at a dose of200—250 mg/m2 administered as a 1-hour intravenous infusion every 21 days for 3—6 treatment cycles in patients with solid tumors of the female reproductive system.Results. The polymeric micellar composition of cremophor EL free paclitaxel can be used in higher therapeutic doses with a lower risk of hypersensitivity and peripheral neurotoxicity. Fatigue and neuropathy were the most common dose-dependent adverse events of this drug. Nonew adverse reactions unknown for paclitaxel have been registered.Conclusions. The possibility of administration of micellar paclitaxel without premedication with steroids or at a minimum dose* makes it a promising candidate for further studies in combination with new targeted drugs and immunotherapy.
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spelling doaj.art-f4335c6089184ac6a7e5c3327ec5c2d72025-03-02T13:05:35ZrusABV-pressОпухоли женской репродуктивной системы1994-40981999-86272019-11-01153374310.17650/1994-4098-2019-15-3-37-43621Micellar paclitaxel in the treatment of patients with tumors of the female reproductive systemA. G. Kedrova0S. E. Krasilnikov1D. A. Astakhov2V. V. Kosyy3Federal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency of RussiaNovosibirsk State Regional Clinical Oncologic DispensaryFederal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency of RussiaFederal Scientific and Clinical Center for Specialized Medical Assistance and Medical Technologies of the Federal Medical Biological Agency of RussiaBackground. Treatment of patients with advanced cancers of the female reproductive system is very challenging. The most common treatment scheme for such patients includes paclitaxel 135—175 mg/m2 + carboplatin AUC 5—6 or cisplatin 75 mg/m2. However, lengthy treatment with this regimen is limited by adverse events, such as neuropathy, allergic reactions, nephropathy, etc. The new micellar form of paclitaxel has demonstrated better tolerability compared to conventional paclitaxel and, considering the increased safe effective dose (up to 250 mg/m2) it should ensure higher efficacy and better progression-free survival. The use of cremophor EL free paclitaxel is recommended in patients with concomitant extragenital diseases (including diabetes and neurological deficit), in elderly patients, and in patients with allergic reactions, as well as in cases when additional steroids should be avoided.Objective: to summarize the experience of using the new form of paclitaxel in patients with tumors of the female reproductive system and concomitant diseases.Materials and methods. We analyzed both world and our own experience in using micellar paclitaxel at a dose of200—250 mg/m2 administered as a 1-hour intravenous infusion every 21 days for 3—6 treatment cycles in patients with solid tumors of the female reproductive system.Results. The polymeric micellar composition of cremophor EL free paclitaxel can be used in higher therapeutic doses with a lower risk of hypersensitivity and peripheral neurotoxicity. Fatigue and neuropathy were the most common dose-dependent adverse events of this drug. Nonew adverse reactions unknown for paclitaxel have been registered.Conclusions. The possibility of administration of micellar paclitaxel without premedication with steroids or at a minimum dose* makes it a promising candidate for further studies in combination with new targeted drugs and immunotherapy.https://ojrs.abvpress.ru/ojrs/article/view/661paclitaxelovarian cancermicellar paclitaxel
spellingShingle A. G. Kedrova
S. E. Krasilnikov
D. A. Astakhov
V. V. Kosyy
Micellar paclitaxel in the treatment of patients with tumors of the female reproductive system
Опухоли женской репродуктивной системы
paclitaxel
ovarian cancer
micellar paclitaxel
title Micellar paclitaxel in the treatment of patients with tumors of the female reproductive system
title_full Micellar paclitaxel in the treatment of patients with tumors of the female reproductive system
title_fullStr Micellar paclitaxel in the treatment of patients with tumors of the female reproductive system
title_full_unstemmed Micellar paclitaxel in the treatment of patients with tumors of the female reproductive system
title_short Micellar paclitaxel in the treatment of patients with tumors of the female reproductive system
title_sort micellar paclitaxel in the treatment of patients with tumors of the female reproductive system
topic paclitaxel
ovarian cancer
micellar paclitaxel
url https://ojrs.abvpress.ru/ojrs/article/view/661
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AT sekrasilnikov micellarpaclitaxelinthetreatmentofpatientswithtumorsofthefemalereproductivesystem
AT daastakhov micellarpaclitaxelinthetreatmentofpatientswithtumorsofthefemalereproductivesystem
AT vvkosyy micellarpaclitaxelinthetreatmentofpatientswithtumorsofthefemalereproductivesystem