Taxol at 40

gdpawel

Touted as the best-selling cancer drug in history began 40 years ago this past summer (2002). Taxol was found to be virtually insoluble in water. "It had the solubility of a brick". The compound wouldn't dissolve very much in any solution. Without a way to get it into a cancer patient, what good was it? It was discovered that something Taxol would dissolve in that "might" work in a reasonably "safe" intravenous solution in humans. It was an elixir made of castor oil and marketed as Cremophor EL. It was the "only" answer. However, this castor-oil carrier is suspected as the culprit behind the misery which includes nausea, vomiting, joint pain, appetite loss, brittle hair and tingling sensations in hands and feet (neuropathy). The much ballyhooed drug was no panacea.

And the picture wasn't all that rosy as a cancer-fighter. Numerous cancer patients had the drug bounce off their tumors, doing little if any good. Of course, no one knew if it was hundreds, thousands, tens of thousands or millions of patients. A lot of cancer patients who succumb, get the wrong information on their death certificates. Death by "side effects of cancer treatment" is not the same as "complications of cancer". Cancer patients die with incorrect, incomplete or misleading diagnoses. Often it will say they died of heart failure, kidney failure, liver failure or lung failure, etc. These can be side effects of cancer treatment as well as progression of the cancer. They are neatly lumped together, reducing the general understanding of the impact of cancer.

The percentage of patients that must respond to a drug before it is approved varies from as high as 80% to as low as 20%. Thereafter, it is used routinely for all patients with the same form of cancer, though unfortunately a drug that helps one person does not necessarily mean it will help all patients with the same diagnosis. God forbid you have a medical oncologist that believes in the one drug(s) fits all patients. And the response rate for Taxol.....30%. Imagine if a patient knew beforehand that Taxol had only a 30% response rate, would that patient take the drug? This is all part of the "informed consent".

Unlike the research being performed at UCLA's Metastatic Brain Tumor Program, which is studying the effects of eliminating "whole brain" radiation from the treatment of brain metastases (debunking the effectiveness of this treatment, once and for all), no one has been doing further research on the matter of "dose intense Taxol and brain metastasis". A NCI observational study in 1995 reported experience in their clinic where recurrent systemic disease occurred in all patients for which they received dose intense Taxol therapy. Brain metastasis was the only site of the disease recurrence, presenting with headache, dizziness, unsteady gait, nausea and vomiting. Perhaps someday, an institution will do the needed research on Taxol, like UCLA is doing on "whole brain" radiation?