Paclitaxel in the treatment of esophageal cancer

Since its introduction, paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) has demonstrated significant antitumor activity in epidermoid carcinomas and adenocarcinomas originating in the esophagus. Paclitaxel is the most active single agent available to treat metastatic esophageal cancer. Combinations of paclitaxel and cisplatin enhance response rates, but the addition of 5-fluorouracil to this combination only increases toxicity without notably augmenting clinical benefit. Paclitaxel also has been incorporated into numerous preoperative regimens for patients with potentially resectable esophageal cancer. While the optimal use of this agent remains undefined in the postoperative setting, it is clear that paclitaxel will be incorporated into the next generation of preoperative chemotherapy or combined chemotherapy plus radiotherapy regimens for operable esophageal cancer.