Perspective Chapter: Appraisal of Paclitaxel (Taxol) Pros and Cons in the Management of Cancer – Prospects in Drug Repurposing

Paclitaxel (Taxol) is potent natural anticancer drug that has evolved over the years. It has been useful in the management of many cancers. Hence, this review aims to appraise the pros and cons of paclitaxel in the management of cancers using literature. Paclitaxel acts by obstructing mitotic spindle formation attributed to clampdown of mitotic clampdown hence arresting the cell cycle at the G2/M phase. Some of the notable side effects of paclitaxel usage include: hair loss, numbness, bone marrow suppression, muscle pain, allergic reactions, diarrhea, etc. Among the mechanism of paclitaxel resistance are P-glycoprotein efflux pumps, mutation in tubulin and alterations in binding regions of β-tubulin, altered function of cytokine expression as well as apoptotic Bcl-2 and p53. Combination of paclitaxel with cisplatin clearly improves the duration of progression-free survival and of overall survival of breast cancer. Paclitaxel which is a valuable natural anticancer drug seems promising in the management of non-cancer diseases such as COVID-19, renal and hepatic fibrosis, inflammation, skin disorders, axon regeneration, limb salvage, and coronary artery restenosis. With the advancement of technology, it is expected that the biosynthesis, chemo-resistance as well as its targeted delivery would unfold and perhaps open new uses and vista to the old drug of about five decades ago