Paclitaxel via 1-hour infusion: rationale and pharmacology

Although the initial choice to evaluate a 3-hour infusion of paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) was arbitrary, the attenuated schedule has since proven safe and active against several neoplasms. Shorter infusions are easier to administer, particularly in combination chemotherapy and combined-modality therapy, prompting our investigations of 1-hour paclitaxel infusions in more than 500 patients and approximately 2,000 treatment courses. The toxicity, activity, and pharmacology of 1- and 3-hour infusions of paclitaxel appear to be similar. Results of phase II trials document that 1-hour paclitaxel infusions can be administered safely, and notable activity has been seen against several neoplasms, including cancers of the lung, breast, and urothelium, as well as advanced squamous carcinomas and tumors of unknown origin. This report also describes some limited pharmacologic data of 1-hour paclitaxel compared with longer infusions.