Taxol (paclitaxel): future directions

Abstract

Paclitaxel is the first of a new class of anticancer agents with a novel mechanism of action. Demonstration of the broad activity of this drug and its unusual effects has refocused attention on tubulin as a target for anticancer drug development. Studies are under way to identify the optimal paclitaxel dose and schedule of administration and the effective combination regimens, and to exploit the drug's radiosensitizing properties. Efforts to define pharmacodynamic relationships and clinical mechanisms of resistance and to assess other potential mechanisms for the drug's anticancer activity are also under way. In addition, other compounds that target the microtubule, some more soluble and some more potent, are in various stages of development. Phase III trials in patients with ovarian, breast, and lung cancer are continuing, and adjuvant breast cancer trials will begin soon. Such trials will establish whether paclitaxel increases the cure rate and/or survival in cancer patients.