Paclitaxel-induced adverse effects: insights into multi-organ toxicities and molecular mechanisms

Area of Science:

• Oncology
• Pharmacology
• Toxicology

Background:

• Paclitaxel (PTX) is a widely used taxane chemotherapy agent effective against various solid tumors.
• Its anticancer efficacy stems from mechanisms like mitotic arrest, mitochondrial damage, and apoptosis induction.
• However, PTX is a non-targeted drug, leading to dose-limiting toxicities that impact patient quality of life.

Purpose of the Study:

• To review and elucidate the pathological mechanisms underlying common clinical toxicities associated with Paclitaxel (PTX).
• To provide a comprehensive overview of PTX-induced side effects, including cognitive impairment, peripheral neuropathy, and organ-specific toxicities.

Main Methods:

• Literature review of existing studies on Paclitaxel (PTX) mechanisms and toxicities.
• Synthesis of pathological pathways implicated in PTX-induced adverse events.
• Categorization of toxicities based on affected systems.

Main Results:

• Identified common PTX toxicities: cognitive impairment, peripheral neuropathy, testicular, pulmonary, cardiac, liver, and kidney toxicity.
• Highlighted that the precise pathological mechanisms for many PTX toxicities remain incompletely understood.
• Presented suggested detailed pathological mechanisms for each reviewed toxicity.

Conclusions:

• Understanding the mechanisms of PTX toxicity is crucial for mitigating side effects and improving patient outcomes.
• Further research into PTX-induced pathological pathways is warranted.
• This review consolidates current knowledge on PTX toxicities, aiding clinical management and future therapeutic strategies.