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The Pharmaceutical Journal
Vol 270 No 7233 p104
25 January 2003

Related websites
NICE guidance (more)
Cancer Cell (www.cancercell.org)

NICE updates paclitaxel guidance

The National Institute for Clinical Excellence has updated its guidance on paclitaxel (Taxol) for ovarian cancer (www.nice.org.uk).

It now recommends that women with ovarian cancer should be offered the choice of either paclitaxel in combination with a platinum-based compound or platinum-based therapy alone (cisplatin or carboplatin) for first-line chemotherapy — usually following surgery. This is a change from the previous guidance that recommended paclitaxel in combination with platinum therapy as the standard therapy following surgery (PJ, 13 May 2000, p716).

The choice of first-line treatment now recommended should also be considered when a relapse occurs, if the initial response to treatment was adequate, says NICE.

Like the earlier guidance, the revised document also recommends that paclitaxel be considered as second-line treatment for women who have not previously received it as first-line therapy.

Gene effect on taxanes Researchers investigating why some tumours respond less well than others to certain drugs have found that high levels of a gene encoding serine-threonine kinases within cancer cells renders paclitaxel and related taxanes less effective.

They genetically engineered cervical cancer cells to increase the expression of proteins encoded by the gene AURORA-A, which they say is found at higher than normal levels in some tumours. They found that when cells were treated with paclitaxel, about twice as many non-engineered cells were killed by the drug as engineered cells. The researchers suggest that their finding, if confirmed, could be used to devise a test to predict the effectiveness of taxane-type drugs (Cancer Cell 2003;3:51).