taxol vs taxotere

Im just curious as to why they just dont use taxotere. I was switched myself to taxotere after extreme allergic reactions to taxol. This seems pretty normal as well. And, I just found out that you dont lose all your hair when just on taxotere!!!!! (I was pretty mad when i found this out) Most other side effects are non exisent or easier to handle. Is Taxol cheaper or something? Why not just make that the ovarian drug of choice?

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Valerie,
Here is the info I was given when I started my treatments. My doctor chose this over Taxol because it is less likely to cause nerve damage(peripheral neuropathy)(I AM AN ARTIST). He told me both drugs are effective but Taxotere is a little easier on the nerves. As you read this, look at my comments in all caps to see how I reacted to Taxotere.

Taxotere ® Generic Name: Docetaxel
http://www.chemocare.com/bio/taxotere.asp

How Taxotere Is Given:
Taxotere is given through a vein (intravenously, IV)
Premedication with a corticosteroid pill starting a day prior to Taxotere infusion for 3 days is given to reduce the severity of fluid retention and allergic reactions. I TOOK THIS

Taxotere Side Effects:
Taxotere side effects are often predictable in terms of their onset and duration TRUE
Taxotere side effects are almost always reversible and will go away after treatment is complete THERE ARE EXCEPTIONS

There is no relationship between the presence or severity of Taxotere side effects and the effectiveness of Taxotere. I WAS TOLD THIS IS TRUE
Taxotere side effects and their severity depend on how much Taxotere is given. TRUE. I WAS SCHEDULED FOR 6 TREATMENTS-THEN GIVEN 8. In other words, high doses of Taxotere may produce more severe side effects). HAPPENED TO ME
Taxotere Side Effects:
Low white blood cell count ( risk for infection) HAPPENED TO ME
Low red blood cell count (anemia) HAPPENED TO ME

Onset: 4-7 daysNadir: 5-9 daysRecovery: 21 daysTHIS CYCLE IS TRUE
Fluid retention with weight gain, swelling of the ankles or abdominal area.SWELLING OF THE ANKLES HAPPENED TO ME. FIVE MONTHS LATER THEY OCCASIONALLY SWELL

Peripheral neuropathy (numbness in your fingers and toes) may occur with repeated doses. HAPPENED TO ME AFTER DOSE #6. MY DOCTOR DECIDED TO GIVE ME TWO MORE TREATMENTS TO BE ON THE SAFE SIDE. I HAD SEVERE FINGERNAIL ISSUES(WRITE ME FOR MORE DETAILED INFO) AND TREATMENT #8 WAS REDUCED TO 1/2 DOSES. NOW FIVE MONTHS AFTER I STILL HAVE PERIPHERAL NEUROPATHY AND FOR ME, THE DOCTOR THINKS IT'S PERMANENT.
Nausea
Diarrhea YES
Mouth sores YES
Hair loss YES
Severe Fatigue and weakness YES
Infection YES.VERY HARD TO HEAL
Nail changes (color changes to your fingernails or toenails may occur while taking Taxotere. In extreme, but rare, cases nails may fall off. YES
After you have finished Taxotere treatments, your nails will generally grow back.)
-------------------
Less common:
Vomiting
Muscle/bone/joint pain (myalgias and arthralgias)YES-STILL SUFFERING WITH THIS
Low platelet count (increased risk of bleeding) YES
Increases in blood tests measuring liver function. These return to normal once treatment is discontinued.
Infusion-related Taxotere side effects (symptoms which may occur during the actual treatment) include:

Allergic reactions (rash, flushing, fever, lowered blood pressure). FLUSHED FACE A FEW TIMES. Happens rarely, usually occurs in the first or second infusion. Frequency is reduced by premedication with corticosteroid starting one day before infusion.

Infusion site reactions (uncommon and generally mild, consist of darkening of the vein,YES
inflammation, redness or dryness of the skin,YES or swelling of the vein YES).
Not all Taxotere side effects are listed above, some that are rare (occurring in less than 10% of patients) are not listed here.
Shortness of breath.YES

I kept a notebook of my side effects. When I look back I can't believe I got through them. Most side effects would come and be gone by the next treatment. By treatment 6,7, & 8. I was getting multiple side effects that overlapped each other and some that weren't going away.

This is my story.

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Taxol/carbo is the gold standard for ovca, and not everyone gets an allergic to it. It worked the first time for me and when I had my first recurrence, we used it again. After 3 treatments I was switched to Taxotere/carbo because of neuropathy that wasn't going away as quickly as it should have between treatments.

You DO lose your hair with Taxotere. Mine was gone with the Taxol and did NOT return when I went on Taxotere. It was at least 3 months after treatment ended before I got some hair. I don't know who told you that you don't lose your hair, but that is not true.

Taxotere is a derivative of Taxol and you basically get the same side effects as Taxol - low blood counts, fatigue, nausea, possible rash, etc. I actually found the nausea much worse with Taxotere, so be prepared to ask for Emend if that happens.

Most importantly, I hope it works for you and you get into remission! Good luck.

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I am on Taxol alone because of a severe reaction to carbo. But my CA125 is going up each month. Did any one else experience this? My Dr is talking about switching to Taxotere plus an oral chemo. I had chemo yesterday and my CA125 again went up.

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Rose 2,
I also had a severe reaction to carboplatin , but continued treatment with Taxotere( Docetaxel) after that for seven months. At first the marker went down rapidly, then stalled around 100 for several months .
Now it is moving up again. So the suggestion was Taxotere + Gemzar, or cisplatin = Gemzar among other option. We are still debating.
Taxotere gave me a serious nail problem, opportunistic infections and loosing some nails. Platins and Taxols are the strongest options for ovarian cancer, so I might just have to deal with it.
Wish you all the best, Edith

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Ever since Taxol went off patent, all the academic oncology groups started running clinical trials to show that whatever drug + Taxotere (a drug which is mostly, if not completely, cross resistant with Taxol) might work 1% better in each clinical trial so that Taxotere can be viewed as the new (so-called) "standard" therapy.

Then there was Abraxane (another taxane). According to the clinical trials, Abraxane did not help patients live longer than the older treatments of taxanes. Abraxane and other cremophor-free verisions of Taxol have not shown any significant advantages over the older medicines. But Taxotere and Abraxane are on patent (Taxol is not). The novel formulations have not stood out as distinctly superior.

As for Taxol + Carboplatin being a gold standard? Two large clinical trials showed that Taxol + platinum combinations were better than a single or other platinum combinations. So, platinum + Taxol became standard therapy.

But then two more very large trials were done, showing that there was no
advantage to giving platinum + Taxol over single agent platinum. And platinum + Taxol also wasn't any better than another non-Taxol combination (not previously tested against platinum + Taxol). But platinum + Taxol remained "standard" therapy, for reasons which are not defensible.

According to the National Cancer Institute's official cancer information website on "state of the art" chemotherapy, it is unclear whether single-agent chemotherapy or combination chemotherapy is "preferable" for first-line treatment. No data supports the superiority of any particular regimen.

As I've said in my recent journal entry, it comes down to individualization. If a drug combination has the capacity to destroy the tumor cells directly, then sufficient drug should be given to achieve this goal. If the drug does not have the capacity to destroy the tumor cell, but works through an effect on angiogenesis, then the drug should be given at a dose consistent with this aim.

Some ovarian cancer patients do have tumors which are equisitely sensitive to platinum. These patients should be treated with aggressive platinum dosing, because you have a good shot at getting a very long term survival. But giving high dose platinum to patients with intrinsically resistant disease doubtless causes more hurt than help.

The problem with averages is that they are averages. What would be more instructive would be to know the proportion of patients who are outside the usual range of outcomes. Instead of blindly mixing and matching drugs to individual cancer patients, what would be more beneficial is to sort out what's the best profile in terms of which patients benefit from this drug or any other drug. Can they be combined? What's the proper way to work with these drugs?

If a drug works extremely well for a certain percentage of cancer patients, identify which ones. If one drug or another is working for some people (not average populations) then obviously there are others out there who would also benefit.

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Did anyone use the ice packs on their hands and feet while the taxotere was being infused? One of the gals that had chemo the same time I did used them and thought they saved her hands and feet. She said she learned about it in a support group. When she started getting really cold, she would remove them from the ice packs. She said the heat just came back in no time at all.

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I never needed anything like that when on Taxotere. Sounds more like something you might do with Doxil - and I'm on Doxil now and have never needed that. I never had a problem with hands/feet while on Taxotere.

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One of my good friend's Mom (BC)had her hands burnt by taxotere. I am sure it makes a difference on the dosage and your response to the drug. If you google taxotere and ice pack, you will see it.

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I had Taxotere/Carbo and lost all my hair a week and a half after the first treatment. Don't count on it being any less harsh than Taxol. After the 6th treatment I got a clean bill of health!

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Although I had allergic reactions to Taxol twice during chemotherapy, I decided to stay on it with a slower drip and more steroids. I had a total of 8 treatments at the maximum dose of Carbo/Taxol and other than losing my hair, I didn't have much in the way of side effects.

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I was given Taxol and Carboplatin when initially diagnosed. When I had a recurrence five years later my wonderful surgeon had chemosensitivity tests ordered which showed that carboplatin was not effective, and my new treatment was to be Taxotere and Doxil. I was wondering, because the second round of treatments (taxotere and Doxil) were easier to take than the Taxol and Carbo., could the difference be because of the neupigen (spelling??) which is given daily after your white counts tank versus the shot you are given the day after chemotherapy (can't think of the name - neurontin possibly?) so your white counts don't get a chance to go so low.
I wish I could think of the name of that drug given the day after a treatment, but all of you know what I am talking about.

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Pattykey,
You probably mean Neupogen and Neulasta for low white blood counts. Neurontin (Gabapentin) is a drug for lessening neuropathy.

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PattyKey,
Extremely low white counts can make you vulnerable to infections and that is why these drugs (neupogen and neulasta) are given but they do not help other side effects.

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Taxol is extracted from the bark of the Pacific Yew and Taxotere is made from the needles of the European Yew tree.

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PattyKey,
You probably got a Neulasta shot (give 24 hrs. after treatment) or Neupogyn (shots 7 days in a row) - both are for low white cell counts. They push the bone marrow to regenerate itself so you treatment isn't delayed.

It has nothing to do with how you react to the chemos involved. Maybe you were just lucky that you had a better reaction to Taxotere and Doxil than you did with the previous chemos. I've had all the chemos you mentioned, and shots of both Neulasta and Neupogyn.

I hope this new combo works for you. Good luck!

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Thank you for jump starting my memory. I was thinking about neuronton because I had to take that for two years after I had a seizure in my onc.'s office following a treatment.

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Yes, but I think when your white count gets so low, that can make you feel pretty miserable, aside from all the other side effects.

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Thank you, Favorite Aunt, for the well wishes. I am happy to say that this is all far behind me, and I hope for good. My initial diagnosis was ten years ago and recurrence was almost five years ago. That's why I had to struggle to remember the names of the drugs used for white cell regeneration. When you are struggling through this, you think you will never forget a single moment, drug, anything, but you do, and that's a good thing.
You get healthy and stay strong. -- Patty

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The most common reasons that Taxotere (Docetaxel) is substituted for Paclitaxel (Taxol) are related to the increased risk of serious hypersensitivity reactions to Paclitaxel, which is formulated in Cremephor-EL (alcohol and polyoxyethylated caster oil), as well as the risk of neuropathy. Taxotere has a greater risk of bone marrow suppression, but with less risk of hypersensitivity reactions and neuropathy.

A new study from the Research on Adverse Drug Events and Reports (RADAR) pharmacovigilance program at Northwestern University Feinberg School of Medicine found cases of hypersensitivity reactions significantly higher with Cremophor-based paclitaxel, a solvent-administered taxane chemotherapy. The report was presented at the 45th Annual Meeting of the American Society of Clinical Oncology held in Orlando, Florida.

Cremophor-containing paclitaxel has been associated with hypersensitivity reactions, with responses ranging from mild skin conditions to more severe effects, including anaphylaxis and cardiac collapse. Current U.S. product labeling for Cremophor containing paclitaxel includes a black-box warning alerting physicians and patients of potential toxicity and recommending the use of corticosteroids and other medications before chemotherapy administration to reduce the risk of hypersensitivity reactions.

What researchers found sobering was that women suffer anaphylaxis despite receiving steroid premedication. Physicians may want to consider exploring other alternative chemotherapy options that do not include Cremophor.

Researchers at Yale School of Medicine reported in the Proceedings of the National Academy of Sciences that there is a molecular basis for the peripheral pain caused by Taxol. It appears to be caused when the drug binds to a protein and initiates improper calcium signaling. The response leads to side effects such as acute hypersensitivity, slower heart rhythms, tingling, numbness and other symptoms.

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Hi gpawelski, thanks so much for your information. I have a question for you, does Taxotere same effective as Taxol as you know? My Oncotech report "Taxol as intermediate drug resistance and Taxotere was tested but results didn't meet Oncotech's quality control standards." Do you know why this happens? Appreciate your input as always.

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