What Is Docetaxel (Taxotere<sup>®</sup>)?
Taxotere® (docetaxel) is a chemotherapy treatment option that has antineoplastic properties (meaning that it acts to prevent or halt the development and growth of tumors). It is indicated for use with prednisone in individuals with metastatic castration resistant prostate cancer (prostate cancer that has spread to other parts of the body and is not responding to treatment to lower the body’s level of testosterone). Docetaxel is administered intravenously (IV injection into a vein) and is typically administered over a 1-hour period once every 3 weeks. Docetaxel is also indicated for the treatment of breast cancer, non-small cell lung cancer, gastric adenocarcinoma, and squamous cell carcinoma of the head and neck cancer (SCCHN).
When chemotherapy is needed, docetaxel is typically the first chemotherapy agent to be used in prostate cancer. In some cases, docetaxel may be used with other chemotherapies or hormone therapies. Individuals taking docetaxel should also be monitored for changes in blood cell counts, serious infections or allergic reactions, severe fluid retention, numbness in the hands and feet, and changes in liver functioning.1
How does docetaxel work?
Docetaxel's active ingredient has antineoplastic properties, meaning that it acts to prevent tumor growth and development. Docetaxel does this by binding to the microtubules in a cell which play a key role in allowing cells to physically divide during the replication process. When a parent cell is unable to split into two daughter cells, it will eventually become too faulty and will die. When a cell manually kills itself because of a faulty cellular process it is called apoptosis. Chemotherapies cause cancer cells to stop dividing and undergo apoptosis, thus, slowing or halting the growth of a cancerous mass.
Cancerous cells are rapidly dividing while most other cells in our body aren’t, or are doing so at a slower rate. This property is what increases the chances of chemotherapies targeting cancer cells. However, there are still a few kinds of cells in our body that divide rapidly, such as hair cells or cells that line our intestines, which explains the common side effects of hair loss or gastrointestinal disruption while on certain chemotherapy medications. Blood cells, including important white blood cells, red blood cells, and platelets also divide on a regular basis, making it important to closely monitor someone on chemotherapy to make sure their blood cell counts aren’t dangerously low. If a person’s blood cell count dips below a certain threshold, they may be unable to receive chemotherapy until the issue has resolved.
Additionally, steroids like prednisone may be used with certain chemotherapies to increase their effectiveness when it comes to targeting and killing cancer cells as well as to prevent life-threatening swelling and other side effects.2
What are the possible side effects of docetaxel?
Multiple clinical trials evaluated the safety and efficacy of docetaxel across many different conditions. The most common side effects of docetaxel include feeling short of breath, decreased appetite, swelling of your limbs, hands, or feet, swelling of your face, fatigue, changes in your sense of taste, constipation, changes in your fingernails or toenails, nausea, vomiting, joint or muscle pain, sores on your mouth, lips or throat, diarrhea, hair loss, redness or watering of eyes, skin reactions at the injection site, and tissue damage if the chemotherapy leaks out of a vein. Many of these side effects, including hair loss, are generally reversible and will be remedied when the medication is stopped. Your provider will be able to determine what side effects may be longer-lasting in nature. This is not an exhaustive list of all potential side effects of docetaxel. Talk to your healthcare provider or pharmacist for further information.
Things to note about docetaxel
Several rare but more serious side effects can accompany docetaxel including neurological symptoms, vision problems, serious fluid retention, changes in liver function, skin reactions, and reproductive health complications. Alert your provider immediately if you notice any of the following symptoms:
- Numbness, tingling, or burning of hands or feet
- Blurred vision or loss of vision
- Extreme swelling of your hands, feet, or limbs
- Redness and swelling of arms or legs
- Peeling skin
Additionally, there is a risk of developing certain blood disorders while taking docetaxel, including the possibility of developing another type of cancer called Acute Myeloid Leukemia (AML) when taking docetaxel with other specific medications. Your doctor will monitor you for any signs of these conditions, however, it is important to disclose to them all other medications you are currently taking before beginning treatment. Individuals with a blood cell count that is deemed to be too low to be able to handle the continuation of treatment will need to stop taking docetaxel until their blood cell count rises because they are at increased risk of infection or bleeding. Contact your provider if you have any signs of infection, including fever, or signs of bleeding, bruising, or blood in the stool.
Docetaxel also has reproductive health risks. Male patients that have female partners who could become pregnant should use contraception during treatment and for 3 months after the last treatment as docetaxel can cause fetal harm (patients should discuss appropriate birth control methods with their doctor).
Before starting docetaxel talk to your provider if you:
- Have any problems with your liver
- Are allergic to docetaxel or any of its ingredients
- Have a low white blood cell count, red blood cell count, or low platelets
- Have any other medical conditions
- Are currently taking any other medications (prescription and over-the-counter), vitamins, or herbal supplements
You should also contact your provider if you notice any signs of an allergic reaction to the medication, including chest pain or difficulty breathing. Docetaxel contains alcohol in amounts high enough to potentially impair your ability to drive or operate any machinery. It is important to limit any of these activities post-treatment until safe to continue. It is also important to consult the prescribing information for any other medications taken with docetaxel, including prednisone.
Docetaxel is administered intravenously (IV), meaning through an injection into a vein. A typical injection of docetaxel takes about an hour to administer and is given once every 3 weeks. Your provider will determine the appropriate dosage and administration schedule for you, including your length of treatment, as well as the appropriate dosage and administration of any other medications taken with docetaxel, such as prednisone. It is important to follow your schedule exactly as instructed, and not to stop taking any accompanying medications on your own. The dose of your docetaxel can be adjusted as needed, and may need to be discontinued if your blood cell count is too low or if the side effects of treatment become too severe. Patients should talk to their doctor if they have any questions, or if they have questions regarding their docetaxel regimen.1
These are not all the possible side effects of docetaxel. Patients should talk to their doctor about what to expect with treatment with docetaxel.