Docetaxel

Docetaxel is a cytotoxic chemotherapy agent in the taxane class used to treat several solid tumors. It is a semi-synthetic compound developed from taxane precursors and is marketed under brand names such as Taxotere. Docetaxel acts by stabilizing microtubules; it binds to beta-tubulin and prevents their disassembly, disrupting mitotic spindle function and leading to cell cycle arrest and cancer cell death.

Docetaxel is used to treat a range of cancers, including metastatic or early-stage breast cancer, non-small cell lung cancer, prostate cancer, gastric cancer, and head and neck cancers. It is often given after other therapies or in combination with other anticancer agents, depending on tumor type and stage. Treatment is typically delivered as an intravenous infusion on a defined schedule, with corticosteroid premedication commonly given to reduce hypersensitivity reactions and fluid retention. The drug is formulated with polysorbate 80, which can contribute to certain infusion-related effects.

Common adverse effects include neutropenia and febrile neutropenia, fatigue, mucositis, nausea, vomiting, diarrhea, alopecia, and nail or skin changes. Fluid retention and edema are notable with docetaxel. Peripheral neuropathy and liver enzyme elevations can occur. Severe hypersensitivity reactions are possible and may require stopping the infusion.

Pharmacokinetically, docetaxel is primarily metabolized in the liver, mainly by cytochrome P450 3A4, and is excreted in bile. Dose adjustments are often required for hepatic impairment and when patients take strong CYP3A4 inhibitors or inducers. Docetaxel was approved in the 1990s and remains a standard option for several solid tumors.