The Evolving Role of Paclitaxel in Breast Cancer and the Ambulatory Care Setting

Not since the introduction of doxorubicin has a drug been as exciting and promising as paclitaxel for the treatment of breast cancer. Currently, the only ap-proved use of paclitaxel in breast cancer is the meta-static setting. Paclitaxel i s being studied in the adju-vant setting to assess its relative efficacy and to theoretically increase the chances of killing all microme-tastases with alternate therapy with a different rnech-anism of cytotoxic activity. The optimal dose and schedule of administration have not been identified. Toxicities differ depending on dose and schedule, and REAST CANCER remains the most com- B nionly diagnosed cancer in women in the United States. An estimated 183,000 new cases will be diagnosed and approximately 46,000 people will die of breast cancer in 199.5. ’ Not since the introduction of doxorubicin has a drug been as exciting and promising as paclitaxel for the treatment of this deadly discase. There have been many interesting discoveries over the last two decades involving paclitaxel and its role in breast cancer treatment. The problems encoun-tered in drug formulation and administration have been overcome, and investigations of pacli-taxel are now being conducted worldwide in a number of scenarios. Paclitaxel’s use in breast cancer is constantly evolving, moving from the metastatic setting into the adjuvant setting with a promising future. The administration of pacli-taxel is also evolving, moving from the costly inpatient setting into the more affordable outpa-tient setting without compromising safety. Un-fortunately, all of these discoveries unveil more unanswered questions. With diligent research into this arena, the answers to these questions will bring a new era to the treatment of breast cancer. BACKGROUND INFORMATION Paclitaxel, one of a novel class of drugs called taxanes, was first discovered in the bark extract From tltc Division of Pltantinq, h1.D. Atiderson Cance