Taxane

What are taxanes?

Taxanes (pronounced “TAK-sayns”) are a class of chemotherapy drugs that treat cancer. Chemotherapy sends medicine through your bloodstream to kill cancer cells and prevent tumor growth. Different classes of chemotherapy drugs use different processes (mechanisms of action) to do this. Taxanes fight cancer by interfering with the process cancer cells use to make more cancer cells.

Taxanes occur naturally in Yew trees. The first taxane, paclitaxel, came from the bark of the Western Yew tree. It’s one of two types of chemotherapy drug classes that originates from plants. The other type is called Vinca alkaloids. Vinca alkaloids occur naturally in periwinkle plants.

Scientists study the makeup of the plant-derived versions of taxanes to make synthetic versions in labs.

How do taxanes work?

Cancer spreads when cancer cells make copies of themselves. Taxanes disrupt the process that cells use to make copies, called cell division or mitosis. For this reason, taxanes are considered “mitotic inhibitors.”

During mitosis, a single cell (the parent cell) copies its genetic material and splits into two identical cells (daughter cells). Taxanes prevent important structures called microtubules from allowing this split to happen. As a result, the parent cell dies.

There are four general phases of mitosis. Taxanes disrupt mitosis at the midpoint phases called metaphase and anaphase.

1. Prophase: Inside the parent cell, identical pairs of chromatids form. Chromatids eventually become chromosomes, the basic genetic building blocks of a cell’s genetic material. Also, a structure called the mitotic spindle begins to form. It consists of proteins called microtubules.
2. Metaphase: The microtubules within the mitotic spindle attach to the chromatids. The chromatids align along the center of the parent cell.
3. Anaphase: The microtubules pull the chromatids apart to opposite ends of the cell. At this point, the chromatids become chromosomes. Identical pairs of chromosomes exist at each end of the cell.
4. Telophase: The parent cell divides into two daughter cells with identical chromosomes.

Taxanes stiffen the microtubules so they’re not flexible enough to move the chromatids in the center of the parent cell (metaphase) to the opposite ends of the cell (anaphase). As a result, daughter cells can’t form, and the parent cell eventually dies.

Which cancers do taxanes treat?

Healthcare providers primarily prescribe taxanes to treat:

• Ovarian cancer.
• Breast cancer.

Taxanes also treat:

• Bladder cancer.
• Cervical cancer.
• Gastrointestinal cancer.
• Head and neck cancers.
• Kaposi sarcoma.
• Lymphoma.
• Non-small cell lung cancer.
• Prostate cancer.
• Uterine cancer.

Healthcare providers may prescribe taxanes alongside other cancer treatments, including other forms of chemotherapy. They may be a first-line treatment for breast cancer. A first-line treatment is the first one prescribed to treat a disease. Often, providers prescribe taxanes to treat advanced cancers after other treatments haven’t worked. They also treat cancers that have spread (metastatic cancer). Scientists are continually researching new uses for taxanes.

How are taxanes given?

Taxanes are given intravenously, which means through an IV. A healthcare provider will administer the drug through a catheter. It will travel through your body via your bloodstream. You may receive the medicine over one hour or several hours. You may need to receive infusions each week or every few weeks.

Your healthcare provider will explain your treatment schedule and describe what to expect during infusions.

What are the side effects of taxanes?

Chemotherapy drugs, including taxanes, fight cancer by killing cells that replicate quickly, specifically, cancer cells. However, they can also harm healthy cells that replicate fast, causing side effects. Fast-dividing cells include skin cells, hair cells, cells in your gastrointestinal (GI) tract and blood cells.

The most common side effects of taxanes include:

• Neutropenia, or low white blood cell counts. Neutropenia can increase your risk of infection.
• Peripheral neuropathy. Some people experience glove and stocking peripheral neuropathy, which involves weakness and numbness in your hands and feet.

Other potential side effects include:

• Muscle pain and joint stiffness.
• Rash at the injection site.
• Nausea and vomiting.
• High blood pressure.
• Low blood pressure.
• Thrombocytopenia.
• Anemia.
• Hair loss.

Specific side effects depend on which taxane drug you receive and the dose you’re given. Your healthcare provider can explain potential side effects to look out for.

How effective are taxanes?

Healthcare providers have prescribed taxanes since the early 1990s, when the U.S. Food and Drug Administration (FDA) first approved paclitaxel for treating advanced ovarian and breast cancer.

Since then, taxanes have become a commonly prescribed chemotherapy drug because of their effectiveness. They kill cancer cells and stop tumor growth. They can extend your life. Studies have shown that taxanes successfully treat metastatic breast cancer, as well as early-stage breast cancer.

Scientists continue to study new ways to use taxanes to fight different types of cancer.

What are the risks of taxanes?

Although they can extend your life, taxanes can cause complications, including serious side effects that may require changing your treatment schedule or stopping treatment. Complications and certain side effects may occur as soon as your first infusion. Occasionally, side effects don’t develop until several months into treatment. Your healthcare provider will review the risks with you before you start taking taxanes.

As with other chemotherapy drugs, taxanes can become less effective over time. This is called chemoresistance. Cancer cells that become taxane-resistant continue to replicate and spread.

If this happens, your healthcare provider may recommend trying taxanes with different combinations of drugs, or they may recommend different treatments altogether. Combating cancer resistance to taxanes and other chemotherapy drugs is an important area of cancer research.

A note from Cleveland Clinic

Taxanes are chemotherapy drugs that stop cancer cells from replicating. The taxanes paclitaxel, docetaxel and cabazitaxel can effectively treat various forms of cancer. They’ve improved survival rates for cancer. Still, it’s important to understand what side effects may accompany treatment so you can plan for them. Work with your healthcare provider to understand what’s involved with treatment so that you can choose the best care plan for you.