First-lineTaxol
Paclitaxel
Taxane microtubule stabiliser
Partner for carboplatin in ovarian and endometrial cancer.
IV
First-line for
- Ovarian, endometrial, cervical, breast cancers (regimen-specific)
Mechanism
Binds β-tubulin → stabilises microtubules → mitotic arrest → apoptosis.
"Paclitaxel = Peripheral neuropathy + Premedicate"
- Dexamethasone + H1 + H2 30 min pre-infusion
- Cumulative sensory neuropathy — dose limiting
- Alopecia universal
Dosing
- Ovarian q3w
- 175 mg/m² IV over 3 h with carboplatin
- Weekly
- 80 mg/m² IV × 3 of 4 weeks
Contraindications
- AbsoluteNeutrophils <1.5 × 10⁹/L
- AbsoluteSevere hepatic impairment
- AbsoluteT1 pregnancy
Side effects
- Peripheral neuropathy
- Myelosuppression
- Alopecia
- Hypersensitivity (Cremophor vehicle)
- Myalgia, arthralgia
Fetal & maternal notes
- • T2/T3 use with MDT; no clear teratogenic signal for T2/T3 exposure
Key interactions
Ketoconazole (CYP3A4)
Caution↑ paclitaxel toxicity
Cisplatin (given after paclitaxel)
Caution↑ myelosuppression if reversed
Clinical pearls
- 💡 Nab-paclitaxel avoids Cremophor and needs no premed
- 💡 Sequence paclitaxel BEFORE carboplatin/cisplatin
Content last reviewed: REPLACE_ME (e.g. 2026-07)
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