Progress of New Formulations of Paclitaxel

Review Article

Austin Oncol. 2016; 1(2):1009.

Progress of New Formulations of Paclitaxel

Shan Xu, Heng Zhang, Shaozhi Fu and Jingbo Wu*

Department of Oncology, The Affiliated Hospital of Southwest Medical University, Southwest Medical University, China

*Corresponding author: Jingbo Wu, Department of Oncology, The Affiliated Hospital of Southwest Medical University, Southwest Medical University, China

Received: June 21, 2016; Accepted: September 02, 2016; Published: September 06, 2016

Abstract

Over the past two decades, paclitaxel shows remarkable potency as an antineoplastic agent with a broad range of cancers, such as lung, ovarian, and pancreatic cancers, etc. However, traditional treatment regimens limited the clinical effectiveness of paclitaxel by high rates of toxicitiessuch as myalgia, hypersensitivity reactions and peripheral neuropathy. These effects mainly were caused by Cremophor EL (polyethoxylated castor oil), a delivery of paclitaxel due to its poor solubility, and ethanol. To overcome these problems, numerous advances have been made in dosing schedules and delivery strategies. This review describes existing and future novel formulations for delivery of paclitaxel. In addition, novel formulations of paclitaxel, their mechanisms of action, dose and administration and clinical efficacy will be discussed.

Keywords: Paclitaxel; Cancer; Chemotherapy

Introduction

Cancer had become the most common cause of death in China and many other parts of the world. Currently, the crude incidence rate in Chinese cancer registration areas was 285.91/100,000 (males 317.97/100,000, females 253.09/100,000) and the cancer mortality in urban areas was 181.86/100,000, whereas in rural areas, it was 177.83/100,000 [1]. A central aim in cancer therapy is to ‘‘cure’’ the cancer, or prolonging survival time of the patients, while improving the quality of life in both the long and short terms [2]. Over the decades, the treatment of cancer has relied primarily on the use of various forms of surgery, cytotoxic chemotherapy and radiation therapy, especially chemotherapy is an important part of treatment for many cancers by keeping the cancer cells from growing and dividing to make more cells [3]. Among the anti-cancer drugs, taxanes are the most researched agents that play important roles in oncotherapy through a unique mechanism, and paclitaxel is the first and most successful member of the taxane family to be used in cancer chemotherapy [4]. Paclitaxel have shown remarkable potency as an antineoplastic agent with a broad range of cancers activity against various cancers, such as lung, ovarian, and pancreatic cancers, etc. The history of development of paclitaxel is summarised in Figure 1. Their therapeutic effect is due to disrupt the tubulin-microtubule equilibrium and destroy the cancer cell division process by inducing cell cycle arrest and the programmed cell death [5-7]. So far, paclitaxel is widely used in the therapy of various cancers. Although crucial progress has been made in curing cancers, chemotherapy with paclitaxel can be associated with significant hypersensitivity reactions, hematologic toxicity, neurotoxicity, arthralgia, myalgia and skin changes that may offset the therapeutic benefits of paclitaxel use. These reactions were mediated by the direct release of histamine or other vasoactive substances, and these reactions have been caused by paclitaxel itself or Cremophor EL [8,9]. Recently, more and more evidences had to be found that those reactions mainly attributed to Cremophor EL, which induced histamine release and similar manifestations in dogs and other drugs formulated in Cremophor EL including cyclosporine and vitamin K, have been associated with similar reactions [10,11]. Therefore, novel formulations of paclitaxel become a hotspot in the treatment of tumors. This article reviews developments in therapeutic strategies of paclitaxel.

Citation: Xu S, Zhan H, Fu S and Wu J. Progress of New Formulations of Paclitaxel. Austin Oncol. 2016; 1(2):1009.