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Brain mets? Combination Taxol and Tamoxefin is showing response according to this study

california_artist's picture
Posts: 864
Joined: Jan 2009

Randomized Study of Paclitaxel and Tamoxifen Deposition into Human Brain Tumors: Implications for the Treatment of Metastatic Brain Tumors


"...Purpose: Drug resistance in brain tumors is partially mediated by the blood-brain barrier of which a key component is P-glycoprotein, which is highly expressed in cerebral capillaries. Tamoxifen is a nontoxic inhibitor of P-glycoprotein. This trial assessed, in primary and metastatic brain tumors, the differential deposition of paclitaxel and whether tamoxifen could increase paclitaxel deposition.
Experimental Design: Patients for surgical resection of their primary or metastatic brain tumors were prospectively randomized to prior paclitaxel alone (175 mg/m2/i.v.) or tamoxifen for 5 days followed by paclitaxel. Central and peripheral tumor, surrounding normal brain and plasma, were analyzed for paclitaxel and tamoxifen.
Results: Twenty-seven patients completed the study. Based on a multivariate linear regression model, no significant differences in paclitaxel concentrations between the two study arms were found after adjusting for treatment group (tamoxifen versus control).

However, in analysis for tumor type, metastatic brain tumors had higher paclitaxel concentrations in the tumor center (1.93-fold, P = 0.10) and in the tumor periphery (2.46-fold, P = 0.039) compared with primary brain tumors...

However, the statistically higher paclitaxel deposition in the periphery of metastatic brain tumors provides functional evidence corroborating reports of decreased P-glycoprotein expression in metastatic versus primary brain tumors. This suggests that metastatic brain tumors may respond to paclitaxel if it has proven clinical efficacy for the primary tumor's histopathology. ..."

I think the key points here are that the combined treatment is most effective if Taxol is used in the treatment of the primary tumor, which it is for UPSC and other uterine cancers, and that the addition of Tamoxefin allows Taxol to break the BBB(blood, brain barrier) which it normally does not.

The paper is a total of 23 pages, all of which I have not read. This is just something I found when looking for other information that I thought would help.

I have already emailed the particulars to Fran, so there is no need for any of you to do that.

I find this to be the most hopeful information regarding brain mets in a very long time.
If you find any difficulty in accessing the information let me know. I have pulled out of the abstract the things I thought most relevant.

I'm just sayin'

Love ya,


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