Preclinical evaluation of docetaxel (Taxotere).

Progress in cancer chemotherapy has been made owing to the discovery and development of drugs that have new structures, new mechanisms of action, and high levels of experimental antitumor activity. Docetaxel (Taxotere; Rhône-Poulenc Rorer, Antony, France) is prepared by semisynthesis from 10-deacetyl baccatin III, an inactive taxoid precursor extracted from the needles of the European yew Taxus baccata. Docetaxel has been found to promote tubulin assembly in microtubules and to inhibit their depolymerization. As predicted by its unique biochemical mechanism of action, docetaxel acts as a mitotic spindle poison and induces a mitotic block in proliferating cells. In vitro, the docetaxel concentrations required to reduce murine and human cell survival by 50% range from 4 to 35 ng/mL, and the cytotoxic effects are greater on proliferating cells than on nonproliferating cells. Docetaxel also is cytotoxic at clinically relevant concentrations against fresh human tumor biopsy specimens (breast, lung, ovarian, colorectal cancer, melanoma) in a soft agar cloning system. Docetaxel has significant in vivo antitumor activity in the different models generally used for the preclinical evaluation of drugs. Eleven of 12 murine transplantable tumors in syngeneic mice have been found to be sensitive to intravenous docetaxel with complete regressions of advanced-stage tumors. Activity also has been observed with human tumor xenografts in nude mice at an advanced stage. In combination studies, synergism has been observed in vivo with 5-fluorouracil, cyclophosphamide, etoposide, vinorelbine, and methotrexate. Preclinical toxicity in mice and dogs has been evaluated by using one and five daily intravenous doses, respectively. The dog was found to be the more sensitive species. The dose-limiting toxicities are hematologic and gastrointestinal in both species. Neurotoxicity also has been observed at high dosages in mice.