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Gastric Cancer Treatment with Docetaxel

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Gastric Cancer Treatment with Docetaxel

What is Docetaxel?

Docetaxel brand name Taxotere is an anti-cancer chemotherapy medication which is classified as an antimicrotubule agent. This medication has been in the market since 2004, and has shown tremendous results among patients.

Docetaxel Mechanism of action

Chemotherapy drugs kills the cancer cells depends upon their ability on how fast they halt the division of cells. Docetaxel medication's main function is to damage the DNA or RNA cells which copy itself in the division. With this drug working, cancer cells are not able to divide, thus leading to death of these cells. Antimicrotubule agents like Docetaxel (Brand Taxotere) inhibits the microtubule structures within cells. These microtubules plays a major role in replicating and dividing of cells, and docetaxel results in the untimely death of these cells.

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Docetaxel side effects -

Common side effects

• Numbness, Burning, pain, or tingling in the arms, hands, legs, or feet
• Stomach, fingers, face, hands, feet, or lower legs gets swelled
• weakness or tiredness
• gain of weight

Less Common side effects

• Black, tarry stools
• blood in the stool or urine
• hoarseness or cough
• difficulty in breathing
• difficult or painful urination
• difficulty in swallowing
• dizziness
• fast heartbeat
• Chills or fever
• skin rash or hives
• itching, swelling or puffiness of the eyelids or nearby eyes, tongue, or lips
• pain in side or lower back
• rattling and noisy breathing
• clear red spots on the skin
• severe red, scaly, peeling, or swollen areas of the skin
• feeling tightness in chest
• while resting feeling trouble in breathing
• unusual bruising or bleeding

Rare side effects

• pain or discomfort in chest
• blood pressure gets decreased
• irregular or unusually fast heartbeat
• blood pressure gets increased

*And If any of the above symptoms reaches a unacceptable or beyond your limits, contact you doctor immediately.

Docetaxel Dose for treatment of Gastric Cancer in Adults

On day 1, 75mg/m2 intravenous dose of docetaxel over 1 hour which is followed by cisplatin 75mg/m2 over 1 – 3 hours which is further followed by 5-fluorocil 750mg/m2 as 24 hours continuous infusion. This should be followed for days 1 to 5, beginning with the end of cisplatin's infusion. And this process is continued for 3 weeks, until there is unacceptable toxicity in the body or the disease progression.

Proving Docetaxel's efficacy in Gastric Cancer

As per FLOT 4 trial's phase 3, perioperative chemotherapy with docetaxel can be considered the new standard care for gastroesophageal junction adenocarcinoma. According to the results of phase 2 trial of FLOT 4, it was observed that combination of docetaxel, oxaliplatin, and fluorouracil/leucovorin was tolerable and has been encouraging rates of pathological response in GEJ adenocarcinoma and gastric cancer patients.

The results were obtained by randomising 716 patients (having a median age of 62 years) to combination of docetaxel, oxaliplatin, and fluorouracil/leucovorin (FLOT) or epirubicin, cisplatin, and capecitabine (ECF/ECX) combination. 356 patients were given the former combination and remaining 360 patients were given the latter combination.

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Between both ECF/ECX and FLOT, baseline characteristics seemed to be similar.

After a follow of almost 3.5 years, it was found out that 203 patients in ECX/ECF group have died as compared to 166 in FLOT group.

The median Overall Survival was 35 months in ECF/ECX group as compared to 50 months in FLOT group. FLOT group also showed improvement in Progression free survival with a median of 30 months as compared to 18 months in ECF/ECX group.

According to the sensitivity analyses, it was observed that FLOT group showed increased rate of curative surgery and prolonged Overall survival and progression free survival as compare to ECF/ECX group.

Both the groups experienced perioperative complications in half patients of their respective groups. The 30-day mortality rate was 3% in ECF/ECX group as compared to 2% in FLOT group and 90-day mortality rate was 8% in ECF/ECX group as compared to 5% in FLOT group.

It was also observed that ECF/ECX group suffered more of grade 3/4 vomiting and nausea and FLOT group suffered more of grade 3/4 neutropenia.

The information provided on the page is meant for the purpose of being helpful and educational. It should not be considered as medical advice.

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