One-hour paclitaxel infusions: review of safety and efficacy

Paclitaxel has emerged as one of the most active anticancer agents in clinical oncology. Hypersensitivity reactions encountered in the clinical development of this drug prompted the implementation of premedication regimens and prolonged infusions, later amended to a 3-hour infusion schedule. Now that paclitaxel is frequently used in outpatient therapy, optimum efficiency in delivery is an issue. A 1-hour drug infusion is more efficient for both the patient and the clinic staff and can help reduce administration costs. This article reviews the current experience with 1-hour paclitaxel infusions.

Published studies using 1-hour paclitaxel infusions, including weekly studies, trials of combination chemotherapy, and combined-modality studies, were reviewed. Studies were evaluated for both efficacy and toxicity.

Paclitaxel administered by 1-hour infusion as part of weekly or every-3-week treatment regimens is active in a variety of tumors, including breast, ovarian, and lung cancer and carcinoma of unknown primary site. Leukopenia, the most common serious toxicity, is usually manageable without hematopoietic growth factor support. The frequency of neurotoxicity appears comparable for 1-hour and 3-hour regimens, and there is no increased risk of hypersensitivity reactions. Infusion duration has been suggested to be an important predictor of response in some tumor types. Evaluation of this issue using a 1-hour paclitaxel infusion as reference is reasonable. One-hour infusions of paclitaxel should simplify outpatient administration, reduce administration costs, and reduce clinic time for patients. Practical information regarding administration of paclitaxel by 1-hour infusion is provided.