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Long-term remission of clear cell carcinoma of the cervix after chemoradiation with 109 cycles of paclitaxel: a case report and literature review.
Lachiewicz, MP, Khanna, N, Gordon, AN, Horowitz, IR
European journal of gynaecological oncology. 2017;(3):456-458
Abstract
BACKGROUND Clear cell carcinoma of cervix (CCCC) is a rare cervical neoplasm that is usually associated with diethylstilbestrol (DES) exposure in utero as a primary risk factor. Advanced stage disease typically has poor outcomes and no evidence-based approach exists to guide clinicians in treating this rare disease. CASE The authors report a case of locally advanced CCCC in a 37-year-old Caucasian female. She underwent chemoradiation therapy that included 109 courses of paclitaxel chemotherapy until no disease could be detected on imaging studies. She is now disease-free 13 years after discontinuing chemotherapy. CONCLUSION A prolonged course of single agent paclitaxel after completing standard radiation therapy was successful in achieving remission in a patient with this rare disease.
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Paclitaxel-induced pneumonitis in patients with breast cancer: case series and review of the literature.
Bielopolski, D, Evron, E, Moreh-Rahav, O, Landes, M, Stemmer, SM, Salamon, F
Journal of chemotherapy (Florence, Italy). 2017;(2):113-117
Abstract
Doxorubicin plus cyclophosphamide followed by paclitaxel is a common adjuvant treatment for high-risk breast cancer. It has been associated with pulmonary toxicity in several case reports. We describe three patients in whom interstitial pneumonitis developed immediately after the first paclitaxel exposure and worsened clinically over time. All reported dyspnoea, fever and progressive respiratory distress. Imaging revealed diffuse bilateral pulmonary infiltrates. Other causes of respiratory failure were excluded with laboratory work-up, imaging, biopsy studies and results of antibiotic treatment. The respiratory decline was reversed only after administration of high-dose steroids, an empirical treatment previously reported to be beneficial in similar cases. Although chemotherapy using concomitant or sequential drugs may make identification of the toxic agent difficult, we noted a clear temporal relationship between exposure to paclitaxel and the development of pulmonary toxicity. Furthermore, according to the available literature, it is less likely that a respiratory decline would be caused by either cyclophosphamide or trastuzumab. In conclusion, clinicians should be aware of the potentially life-threatening risk of pulmonary toxicity following paclitaxel treatment. If paclitaxel is halted early and the patient has good lung reserve, pulmonary toxicity can be reversed with high-dose steroid administration.
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3.
Hand-foot syndrome caused by docetaxel with no recurrence after switch to paclitaxel, a different taxane.
Corazza, M, Minghetti, S, Borghi, A, Virgili, A, Ballardini, P
International journal of dermatology. 2014;(3):e180-2
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4.
Complete response to second line Paclitaxel every 2 weeks of eyelid kaposi sarcoma: a case report.
Brunetti, AE, Guarini, A, Lorusso, V, Minoia, C, Sabatelli, A, Marech, I, Silvestris, N
Ophthalmic plastic and reconstructive surgery. 2013;(5):e114-5
Abstract
A 77-year-old male patient presented to our attention with violaceous nodular lesions on the skin of his hands and lower extremities. Clinical and histologic examination supported the diagnosis of Kaposi sarcoma. A first-line systemic chemotherapy based on liposomal doxorubicin at a dosage of 40 mg/m2 every 3 weeks for 5 cycles was carried out, resulting in partial resolution of skin lesions. However, 1 year later, a relapse of the disease in the lower limbs and a new lesion of the left eyelid were found, therefore the patient began a second-line therapy with 100 mg/m2 paclitaxel every 2 weeks. After 8 cycles of therapy, we observed a complete remission of eyelid tumor and a partial response of lower limbs lesions up to 6 months of follow up. In conclusion, eyelid Kaposi sarcoma was successfully treated with paclitaxel every 2 weeks, obtaining a complete response.
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5.
Paclitaxel-based chemotherapy for aggressive kaposiform hemangioendothelioma of the temporomastoid region: Case report and review of the literature.
Funato, M, Fukao, T, Sasai, H, Hori, T, Terazawa, D, Kanda, K, Ozeki, M, Mizuta, K, Hirose, Y, Kaneko, H, et al
Head & neck. 2013;(8):E258-61
Abstract
BACKGROUND Kaposiform hemangioendothelioma (KHE) is a rare vascular tumor of infancy and childhood. This tumor results in poor prognosis, and therefore, development of a more effective treatment is needed. METHODS AND RESULTS We describe an 11-year-old boy presenting with left facial palsy caused by aggressive KHE of the left temporomastoid region. He was treated with paclitaxel-based chemotherapy, because of the difficulty with complete surgical resection for anatomic factor, multiple lung metastases on diagnosis, and no response to conventional treatments. This treatment reduced the volume of primary tumor and lung metastatic lesions, but the efficacy was transitory. CONCLUSIONS Paclitaxel-based chemotherapy for aggressive KHE may be effective, therefore the multimodality therapy including paclitaxel of aggressive KHE, particularly in the head and neck, needs to be investigated in further studies.
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6.
Paclitaxel-associated subungual pyogenic granuloma: report in a patient with breast cancer receiving paclitaxel and review of drug-induced pyogenic granulomas adjacent to and beneath the nail.
Paul, LJ, Cohen, PR
Journal of drugs in dermatology : JDD. 2012;(2):262-8
Abstract
Subungual and periungual pyogenic granuloma occur in association with certain systemic medications. Paclitaxel is an antitumor drug of the taxane family used in the management of breast cancer. Taxanes have many associated nail changes that may occur in patients receiving either docetaxel or paclitaxel for systemic chemotherapy. The nail changes in a 68-year-old woman with metastatic breast cancer who presented for nail changes after receiving 12 cycles of weekly paclitaxel are described herein: nail plate red-brown discoloration, onycholysis with leukonychia, proximal subungual hemorrhage, and subungual pyogenic granuloma. The literature on systemic medications associated with the development of subungual and periungual pyogenic granulomas is reviewed; drugs associated with the development of pyogenic granuloma at the locations include antineoplastics, antiretrovirals, epidermal growth factor receptor inhibitors, immunosuppressants and retinoids. In conclusion, subungual pyogenic granuloma can occur not only in patients receiving docetaxel, but also in patients treated with paclitaxel. And, paclitaxel should be included in the list of drugs associated with the occurrence of subungual pyogenic granuloma.
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Successful treatment with three-weekly paclitaxel of an anthracycline-refractory classical Kaposi's sarcoma.
Silvestris, N, Galetta, D, Colucci, G
Anticancer research. 2009;(2):675-6
Abstract
Paclitaxel has been approved as second-line therapy after anthracyclines in AIDS-Kaposi's sarcoma (KS) patients. To date, only one patient with classical KS and treated with standard dose (175 mg/m2) 3-weekly paclitaxel as first line therapy has been reported in the literature. Herein, the first case is presented of a patient with anthracycline-refractory classical KS who was treated with standard dose 3-weekly and paclitaxel after five cycles of therapy achieved a partial response according to the AIDS Clinical Trials Group criteria.
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Significant response after treatment with the mTOR inhibitor sirolimus in combination with carboplatin and paclitaxel in metastatic melanoma patients.
Meier, F, Guenova, E, Clasen, S, Eigentler, T, Forschner, A, Leiter, U, Zielinski, C, Knaudt, B, Garbe, C, Berneburg, M
Journal of the American Academy of Dermatology. 2009;(5):863-8
Abstract
Melanoma is highly resistant to chemotherapy. In melanoma, the PI3K-AKT-mTOR signaling pathway is constitutively activated through multiple mechanisms. Several experimental studies suggest that targeting the PI3K-AKT-mTOR signaling pathway is a promising strategy to overcome chemoresistance. This is the first report describing a chemosensitizing effect of mTOR inhibition in patients with melanoma. We report two cases of patients with metastatic melanoma who showed significant remission after combination of carboplatin and paclitaxel with the mTOR inhibitor sirolimus. Our case report, together with the literature discussed, suggests that mTOR inhibition possibly enhances the sensitivity of melanoma cells to chemotherapy and should prompt in-depth and clinical investigation.
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9.
Weekly paclitaxel for a patient with advanced gastric cancer.
Yamamoto, S, Tanaka, Y, Ito, T, Aono, T, Morimoto, Y, Kitagawa, T, Kurihara, Y
Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association. 2003;(2):117-21
Abstract
A 56-year-old woman diagnosed with gastric cancer was admitted to our hospital for operation on May 15, 2001. The operation was performed on May 23. The tumor formed a large mass from the antrum to the head of the pancreas, and cancer cells were detected in the ascitic fluid microscopically. During the operation, resection was impossible, and so 100 mg of cisplatin (CDDP) was infused into the abdominal cavity. After the operation, she experienced continuous nausea and there was a discharge of 1200-1600 ml of digestive fluid per day from her nasogastric tube. On July 17, a new regimen, of 4-week courses of chemotherapy, with weekly administrations of 65 mg/m2 of paclitaxel, along with premedication for 3 weeks, followed by 1 week of rest, was started. After the first of these 4-week courses, the discharge from her nasogastric tube decreased to 200-600 ml per day, and the tube was removed 78 days after insertion. Oral intake of food increased smoothly, and she was discharged on September 14. After another, short, hospitalization, she was discharged on October 20, and she has been coming to our outpatient clinic once a week. After paclitaxel was started, gastric fiberscopy and computed tomography (CT) scan showed reduction of the tumor. Of special note was the disappearance of a scitic fluid after two courses, rated as a "partial response" (Japanese classification). There was a decrease in hemoglobin, but neither leukocytopenia nor a decrease in platelets was found. Neuropathy was slight and no treatment was needed. Now, after 1 year, 11 courses of chemotherapy have been administered at the outpatient clinic. These results suggest weekly administration of paclitaxel to be a promising treatment for advanced gastric cancer with peritoneal dissemination. The therapeutic efficacy should be confirmed by further clinical trials.
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10.
Second-line therapy of ovarian cancer with Paclitaxel administered by both the intravenous and intraperitoneal routes: rationale and case reports.
Markman, M, Kulp, B, Peterson, G, Kennedy, A, Belinson, J
Gynecologic oncology. 2002;(1):95-8
Abstract
BACKGROUND A strong rationale can be proposed to support the delivery of paclitaxel by both the intravenous and the intraperitoneal routes in the management of ovarian cancer. This includes efforts to increase the concentration and duration of exposure of this cycle-specific agent within the body compartment (regional therapy) and a desire to optimize delivery of drug to tumor by capillary flow (systemic therapy). CASE REPORTS Two patients cared for in the Gynecologic Cancer Program of the Cleveland Clinic Foundation provided an opportunity to explore, in a preliminary manner, the feasibility and toxicity of this unique approach. Both patients demonstrated reasonable tolerance of the dual-route management strategy. CONCLUSION In a carefully selected patient population, the administration of paclitaxel both systemically and regionally is a rational management strategy. Randomized controlled clinical trials will be required to determine if this approach is superior to standard intravenous drug delivery.