Ramalingam Sakkaraiappan, Belani Chandra P
University of Pittsburgh School of Medicine, PA, USA.
Expert Opin Pharmacother. 2004 Aug;5(8):1771-80. doi: 10.1517/14656566.5.8.1771.
Paclitaxel, a tubulin-binding agent, is widely used for the treatment of non-small cell lung cancer (NSCLC). The combination of paclitaxel and a platinum compound is an approved regimen for the treatment of advanced NSCLC. The dose-limiting toxicity of paclitaxel is myelosuppression when administered on a prolonged infusion schedule, whereas neuropathy is more common with short infusions. Although the 3-weekly schedule of paclitaxel is the commonly utilised regimen for the treatment of advanced NSCLC, the weekly regimens appear to be associated with lesser myelosuppression and neuropathy. A randomised clinical trial is currently underway to compare the efficacy of the weekly versus 3-weekly regimen of paclitaxel, in combination with carboplatin for the treatment of advanced NSCLC. The radiosensitising effect of paclitaxel has led to its incorporation into multi-modality treatment of NSCLC patients in combination with thoracic radiation. Paclitaxel has also demonstrated synergistic interaction with several molecularly-targeted agents and is at present being evaluated in the neoadjuvant and adjuvant treatment settings for early stage NSCLC.
紫杉醇是一种微管结合剂，广泛用于治疗非小细胞肺癌（NSCLC）。紫杉醇与铂类化合物联合使用是治疗晚期NSCLC的一种获批方案。当采用延长输注方案给药时，紫杉醇的剂量限制性毒性是骨髓抑制，而短时间输注时神经病变更为常见。尽管每3周一次的紫杉醇方案是治疗晚期NSCLC常用的方案，但每周方案似乎与较轻的骨髓抑制和神经病变相关。目前正在进行一项随机临床试验，比较紫杉醇每周方案与每3周方案联合卡铂治疗晚期NSCLC的疗效。紫杉醇的放射增敏作用已使其被纳入NSCLC患者与胸部放疗联合的多模式治疗中。紫杉醇还与几种分子靶向药物表现出协同相互作用，目前正在早期NSCLC的新辅助和辅助治疗环境中进行评估。
