Until mass screening programs for GECs become available in Western
countries, such as those already available in Japan, most GECs will continue to be diagnosed at more advanced stages. Overall, the prognosis of patients with GECs is poor, and it is particularly dismal for those with unresectable disease. To improve surgical outcomes or meaningful survival benefits, new effective cytotoxic or biologic targeted systemic therapies are needed for both resectable and unresectable or metastatic GECs. Since 2006, the FDA has added a new indication for GECs to several cytotoxic Inhibitors,research,lifescience,medical agents. The main benefit of modifying older cytotoxic agents is an improved toxicity profile; examples of modified cytotoxic agents include oxaliplatin, which is a third-generation platinum, and capecitabine and S-1, which are modified or newer formulations of 5-FU. Prior to 2007, paclitaxel and docetaxel were already being used to treat patients with other solid tumor malignancies, Inhibitors,research,lifescience,medical but they did not have an FDA-approved indication for treating patients with GECs. In Inhibitors,research,lifescience,medical this paper, we will review the current roles taxanes in the management of GECs and discuss the future directions of their use. Taxanes Paclitaxel and docetaxel belong to the Taxane family because of their chemical structures contain a common three phenols ring. The clinical application of
taxanes in the management of GECs predates their approval by the FDA for such an indication. It was not until 2006 that docetaxel received FDA approval for use as a first-line treatment in therapy-naïve patients with advanced GECs (11). Taxanes are di-terpenes produced by the Apitolisib in vivo plants of the genus Inhibitors,research,lifescience,medical Taxus (yews). As their name suggests, taxanes were first derived from natural sources, but now they are all synthesized artificially. The two most commonly used taxanes are paclitaxel and docetaxel. Although all taxanes are currently used to treat patients with GECs, only docetaxel has Inhibitors,research,lifescience,medical an FDA-approved indication for use in combination with
cisplatin and 5-FU to treat patients with GECs. Paclitaxel and docetaxel both have therapeutic indications for many solid tumor malignancies. However, only docetaxel has an FDA-approved indication for the treatment of advanced GECs. Paclitaxel Edoxaban has FDA-approved indications as a single agent for second-line therapy for metastatic ovarian cancer (12)-(16), for adjuvant treatment of node-positive breast cancer (17), and for second-line therapy for metastatic breast cancer (18), as well as for second-line therapy for Kaposi’s sarcoma (19). In combination with cisplatin, paclitaxel is also indicated as first-line therapy for metastatic non-small cell lung (20) and ovarian (21),(22) cancers. Docetaxel was introduced at the end of the 1990s; it was first approved in 1996 for the treatment of refractory metastatic breast cancer (23)-(25).