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  • Review Article
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Weekly paclitaxel in the treatment of recurrent ovarian cancer

Nature Reviews Clinical Oncology volume 7, pages 575–582 (2010)Cite this article

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Abstract

Weekly paclitaxel is a highly active and well tolerated regimen that is increasingly being adopted for the treatment of relapsed ovarian cancer. This regimen is usually administered at 80–90 mg/m2/week, and the use of a 1 h infusion helps minimize myelosuppression. When compared with the 3-weekly schedule, weekly paclitaxel is better tolerated, with a reduced frequency of grade 3–4 toxic effects. Single-agent weekly paclitaxel for relapsed ovarian cancer yields response rates in the range of 20–62%; however, response duration can be short. Responses to weekly paclitaxel have been observed in patients whose tumors are resistant to 3-weekly paclitaxel. The level of activity of weekly paclitaxel for relapsed disease has led to its detailed evaluation in the first-line setting, and interest has been enhanced by the results of a Japanese Gynecological Oncology Group study that demonstrated a survival advantage for weekly paclitaxel compared with 3-weekly paclitaxel in combination with carboplatin as initial treatment. The enhanced efficacy of weekly paclitaxel may be due to greater drug exposure, a direct antiangiogenic effect, or both. Current research topics include the combination of weekly paclitaxel with molecular-targeted agents and the use of molecular profiling to better select patients for treatment.

Key Points

  • Weekly paclitaxel is usually administered at 80–90 mg/m2/week, making use of a 1 h infusion to help minimize myelosuppression

  • Patients with relapsed ovarian cancer are increasingly being treated with weekly paclitaxel as a result of the high response rates seen with this well-tolerated regimen

  • Weekly paclitaxel is generally better tolerated than 3-weekly paclitaxel, with a reduced risk of grade 3–4 toxic effects

  • Responses to weekly paclitaxel have been observed in patients who have developed progressive disease within 6 months of prior taxane therapy

  • The enhanced efficacy of weekly paclitaxel may be due to greater drug exposure, a direct antiangiogenic effect, or both

  • Studies are assessing the combination of weekly paclitaxel with molecular-targeted agents and the use of molecular profiling to better select patients for treatment

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Acknowledgements

The Drug Development Unit of the Royal Marsden National Health Service Foundation Trust and The Institute of Cancer Research is supported in part by a program grant from Cancer Research UK. Support was also provided by the Experimental Cancer Medicine Center (to The Institute of Cancer Research) and the National Institute for Health Research Biomedical Research Center (jointly to the Royal Marsden National Health Service Foundation Trust and The Institute of Cancer Research).

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  1. Section of Medicine, The Royal Marsden Hospital and The Institute of Cancer Research, Sutton, SM2 5PT, Surrey, UK

    Richard D. Baird, David S. P. Tan & Stan B. Kaye

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R. D. Baird and D. S. P. Tan are joint first authors of this manuscript. All authors contributed to the research of data, discussion of content, writing and editing of this Review.

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Correspondence to Stan B. Kaye.

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Baird, R., Tan, D. & Kaye, S. Weekly paclitaxel in the treatment of recurrent ovarian cancer. Nat Rev Clin Oncol 7, 575–582 (2010). https://doi.org/10.1038/nrclinonc.2010.120

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