Weekly administration of docetaxel (Taxotere): summary of clinical data

Docetaxel (Taxotere; Rhône-Poulence Rorer, Antony, France) is a highly efficacious antineoplastic agent; however, its administration every 3 weeks produces substantial myelosuppression. Based on recent observations that the administration of paclitaxel on a weekly schedule minimizes myelosuppression, investigation of weekly docetaxel has been initiated. A recently completed phase I study of weekly docetaxel demonstrates markedly decreased myelosuppression with this schedule. The maximum tolerated dose was 43 mg/m2/wk; with this dose, myelosuppression was mild and the dose-limiting toxicity was fatigue/asthenia. Other nonhematologic toxicities were uncommon when doses of less than 40 mg/m2/wk were administered. Edema was not observed, in spite of an abbreviated dexamethasone schedule (8 mg every 12 hours for three doses, beginning 12 hours before docetaxel). A 50% response rate using docetaxel 35 to 40 mg/m2/wk has been achieved in patients with metastatic breast cancer. When used concurrently with radiation therapy, weekly scheduling allowed a maximization of docetaxel dosing, with the maximum tolerated dose being 20 mg/m2/wk. It is likely that this novel schedule of docetaxel will allow the drug to be used with decreased toxicity and will facilitate its incorporation into active combination regimens. Further investigation of this novel schedule of administration is warranted.