Adult Dosing
Breast cancer
Locally advanced or metastatic breast cancer after failure of prior chemotherapy
- 60-100 mg/m2 IV over 1 hr q3 wks
Operable node-positive treatment
- 75 mg/m2 IV q3wks, 1 hr after doxorubicin 50 mg/m2 and cyclophosphamide 500 mg/m2 q3 wks x 6 courses
Non-Small Cell Lung Cancer
Treatment after failure of prior platinum-based chemotherapy
- 75 mg/m2 IV over 1 hr q3 wks
Chemotherapy-naïve non-small cell lung cancer
- 75 mg/m2 IV over 1 hr, immediately followed by cisplatin 75 mg/m2 over 30-60 mins q3 wks
Prostate cancer
- 75 mg/m2 IV over 1 hr q3 wks, in combination with Prednisone 5 mg PO bid
Gastric adenocarcinoma
- 75 mg/m2 IV over 1 hr q3 wks
- Followed by cisplatin 75 mg/m2 IV over 1-3 hrs
- Followed by fluorouracil 750 mg/m2/day as 24 hrs IV infusion x 5 days
Head and Neck Cancer
Induction chemotherapy followed by radiotherapy (TAX323)
- 75 mg/m2 IV over 1 hr q3 wks x 4 cycles
- Followed by cisplatin 75 mg/m2 IV over 1 hr
- Followed by fluorouracil 750 mg/m2/day as 24 hrs IV infusion x 5 days
Induction chemotherapy followed by chemoradiotherapy
- 75 mg/m2 IV over 1 hr q3 wks x 3 cycles
- Followed by cisplatin 100 mg/m2 IV over 30 mins-3 hrs
- Followed by fluorouracil 1000 mg/m2/day as 24 hrs IV infusion x 1-4 days
Notes:- Premedicate all patients with oral corticosteroids to reduce the incidence and severity of fluid retention and hypersensitivity reactions
- See package insert for toxicity related dose adjustments
Pediatric Dosing
- Efficacy in pediatric patients has not been established
[Outline]
- Treatment-related mortality associated with docetaxel therapy has been reported more frequently in patients with abnormal liver function, receiving higher doses, patients with non-small cell lung carcinoma and prior treatment with platinum-based chemotherapy receiving 100 mg/m2 as a single agent [US Black Box Warning]
- Do not administer docetaxel in patients with combined abnormalities of transaminases and alkaline phosphatase [US Black Box Warning]
- Monitor peripheral blood cell counts of all patients receiving docetaxel therapy. Do not retreat with subsequent cycles of docetaxel until neutrophils recover to a level >1500 cells/mm3 and platelets recover to a level > 100,000 cells/mm3[US Black Box Warning]
- Severe hypersensitivity reactions have been reported in patients premedicated with 3 days of corticosteroids. Closely monitor the patient for hypersensitivity reactions, especially during the first and second infusions [US Black Box Warning]
- Docetaxel can cause severe fluid retention, premedicate the patient with oral corticosteroids to reduce the incidence and severity of fluid retention and closely monitor the patients with pre-existing effusions[US Black Box Warning]
- Acute myeloid leukemia (AML) or myelodysplasia has been reported with anthracyclines and/or cyclophosphamide including use in adjuvant therapy for breast cancer
- Docetaxel can cause localized erythema of the extremities with edema followed by desquamation, consider dose adjustments in case of severe skin toxicity
- Severe neurosensory symptoms like paresthesia, dysesthesia, pain have been reported with docetaxel therapy in breast cancer patients. Consider dose adjustment if these symptoms occurs and if symptoms persist discontinue the treatment
- Cystoid macular edema (CME) has been reported in patients treated with docetaxel. Patients with impaired vision should undergo a prompt ophthalmologic examination. If CME is diagnosed, discontinue docetaxel and initiate appropriate treatment
- Severe asthenia lasting for few days up to several weeks or associated with deterioration of performance status in patients with progressive disease have been reported in metastatic breast cancer patients
- Docetaxel can cause fetal harm when administered to a pregnant woman. Advise patient not to become pregnant while undergoing the treatment and if the patient becomes pregnant while receiving this drug, the patient should be apprised of the potential hazard to the fetus
Cautions: Use cautiously in
- AST/ALT >1.5-
5 x ULN with AP >2.5-5 x ULN - Pre-existing effusions
- Women with child bearing potential
Pregnancy Category:D
Breastfeeding: Safety unknown; excretion of docetaxel in human milk is unknown, but as many drugs are excreted into human milk manufacturer advises to either discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
