Effectiveness of cold cap in the prevention of docetaxel-induced alopecia
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The taxoid drugs, docetaxel (Taxotere) and paclitaxel (Taxol), represent a new class of antitumour agents which act by promoting the assembly and inhibiting the disassembly of microtubules. Docetaxel has been shown to be more potent than paclitaxel with regard to the formation and stabilization of microtubules in vitro. Docetaxel also has a higher cell uptake than paclitaxel and a longer intracellular retention time. Docetaxel is a more potent antitumour agent than paclitaxel in most model systems. The observation that the cytotoxic concentration for docetaxel is lower than that for paclitaxel in cultures of human haematopoietic cells supports the clinical observation that dose-limiting neutropenia is seen at a lower dose of docetaxel than paclitaxel. The concentration of docetaxel required to kill tumour cells in vitro is well within the plasma concentrations recorded in clinical studies, and docetaxel has shown extensive clinical activity against a variety of solid tumours. Most drugs are used in combination regimens in the clinic and combinations of docetaxel with other agents are under active investigation. The agents to be combined with docetaxel include those which showed synergism with docetaxel in vitro and can be delivered at optimal doses without additive toxicity.
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It has become clear over the past 10 years that docetaxel, a semisynthetic taxoid antineoplastic agent, is among the most promising compounds to have been developed in the 1990s for the treatment of breast cancer. Data indicate that this drug became standard therapy in the treatment of patients with metastatic disease who have failed anthracycline treatment, and secondarily showed very encouraging results in the first-line metastatic setting either in monochemotherapy or when docetaxel was combined with an anthracycline. More recently, docetaxel also became one of the standard therapies in the adjuvant and neoadjuvant settings, and a promising partner for novel biologic therapies. Current research is further exploring the effect of docetaxel on outcome of early breast cancer in order to fully determine the extent that this chemotherapeutic agent will change the natural history of breast cancer.
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Systemic chemotherapy provides improvement in both survival and quality of life for patients with advanced non-small-cell lung cancer (NSCLC). Docetaxel is the only agent currently approved for both first- and second-line treatment of advanced NSCLC. Multiple randomized clinical trials have established the efficacy of platinum–docetaxel regimens for the first-line treatment of advanced NSCLC. Carboplatin-based regimens and nonplatinum combinations with docetaxel also have proven efficacy in first-line therapy. Combinations of docetaxel with various novel targeted agents have produced encouraging data in Phase II trials. This review article summarizes recent studies of docetaxel as a single agent and in combination regimens with cytotoxic or targeted therapies in the management of patients with advanced NSCLC.
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Paclitaxel was the first taxoid to become available. It was found to be an active anticancer agent but with significant toxicity. Docetaxel is a semisynthetic taxoid and the next of a fast-expanding class of drugs. Studies suggest that docetaxel may be more effective and less toxic than paclitaxel.
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