Taxanes

Taxanes are naturally occurring mitosis-inhibiting cytostatic drugs, i.e. substances that inhibit cell division. Chemically speaking, taxanes belong to the diterpenoids (diterpenes). This group of substances has been used in oncological therapy since the late 1990s.

Taxanes were obtained in the 1960s in the USA from samples of the bark of the Pacific yew (Taxus brevifolia). Such bark extracts were effective against several leukemia cell lines in mice. The active ingredient of the yew extracts was later isolated and defined as paclitaxel. At the end of 1990, a technical route was found for the mass production of the cytostatic drug. In 1993, paclitaxel (trade name ^Taxol®) was approved in Germany for the treatment of ovarian cancer.

Docetaxel, a derivative of paclitaxel, was later synthesized from the needles of the European yew (Taxus baccata). Docetaxel works at a lower dose than paclitaxel and is indicated for breast carcinoma, non-small cell lung carcinoma, gastric carcinoma, head and neck carcinoma and prostate carcinoma.

Another taxane is cabazitaxel, a docetaxel derivative. It is used in second-line therapy for hormone-refractory metastatic prostate cancer.

• Paclitaxel (ovarian and breast carcinoma)
• Docetaxel (breast carcinoma, non-small cell brochial carcinoma)
• Cabazitaxel (hormone-refractory metastatic prostate cancer)

Taxanes inhibit cell division by interfering with the depolymerization and thus the degradation of the microtubules of cells. This inhibits the physiological dissolution of the microtubular cytoskeleton and thus the degradation of the mitotic spindles. This leads to cell death in the G2 phase or M phase of cell division.

Taxanes cause a number of dermatological side effects: multiforme exanthema, hand-foot syndrome, hair loss, folliculitis.

The tubular microtubules form the spindle apparatus of the cells.

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3. Sibaud V et al (2016) Dermatological adverse events with taxane chemotherapy. Eur J Dermatol 26:427-443.