please clarify - taxol, abraxane - differences?

[Pam P]

I'm on taxol & avastin. I know taxol & abraxane are in the same family. But i'm confused on how similar they are.

I've read they are 'packaged' differently so that the abraxane doesn't require the pre-meds, but the taxol does. Other than that are there more differences in the drug or are they the same thing?

If they are the same, then are the s/e the same? And why would it be beneficial to change from one to the other when one stops working? I'm curious. Thanks.

[Sheila]

Pam,

Taxol and Abraxane are both Taxanes, but the medium they are withis different, Abraxane is like 5 times the price, newer, generally causes no hair loss, no premeds needed as it does not contain the chemical cremaphor, amde from pine trees which MANY people are highly allergic to. Most insurances, are cost wise, and will not order Abraxane until you fail on Taxol....go figure, I've been trying to get it for over a year!
For a really good look at the difference, go to www.chemocare.com (http://www.chemocare.com) and look them up!

[chrisy]

Sheila of course is all over the Taxol vs Abraxane question! The Abraxane is and albumin bound molecule so it can be safely administered without the cremaphor solution. This also means that higher doses of the taxane can be made available to kill the cancer.

I've heard, however, that although insurance companies will fight paying for the superior drug, sometimes you can appeal on the basis of toxicity of the taxol, not only if it fails.

[Becky]

Abraxane and Taxol are the same drug active but Abraxane (as Chrisy said) is further reacted with albumin (and a sugar molecule) so that the resultant is water soluble. Taxol by itself is not water soluble so it must be emulsified with Cremophor EL (which is highly refined castor oil ethoxylate). It is the Cremophor EL that people are allergic to which is why benadryl and decadron are given as premeds. Since Abraxane is self emulsifying, you do not need the premeds.

Abraxane is also more bio-useable (probably because none of it is bound up with emulsifier) so it is tauted to be better.

[Pam P]

Thank you for the clarification. Seems like the abraxane should just replace taxol in use.

Since its the same active drug in both that kills the cancer cells, how is it that one could fail at taxol & then abraxane would be effective? Wouldn't it be the same?

[Sheila]

Pam
They are the same but sometimes can react different on a tumor...like when one takes a break from a chemo drug and can go back and receive results again...its all about mixing it up to keep those c cells at bay. Just wondering, why are you not taking Herceptin with the Taxol, Avastin? I have been on the Herceptin continuously even when the chemos fail and they get changed?

[Unregistered]

Cancer cells are not all the same.

A cancer colony is made up of "mutants." The cells are inherently unstable. When they reproduce, they do not produce identical twins like they should.

Sooo...when you see pathology reports that say ER + and give a percentage (80%), that means that 80% of the sample has ER receptors on it.

So, when you took taxane the first time, it successfully killed some percentage of the cancer colony (let's say 90%).

The remaining cells were resistant or dormant (?).

You went off of chemotherapy.

The cancer cells "bloomed" and began producing a new colony...or you produced a new primary.

The new colony is a colony of mutants. They are inherently unstable.

There is no "rule" that says the new colony is resistant to taxane.

Probability is that the taxane will be very effective.

Taxane will no longer be effective when

a. you have reached your life time maximum dose...chemotherapy is "poison." (When you have maxed out taxanes, you will have to switch to another category of drug...much more likely that you will develop resistance / allergy to the preservatives in taxol & taxotere before you reach your life time max dose...thus, the switch to Abraxane for heavily pre-medicated patients)

b. you kill all of the colony that can be killed by taxanes and there is a large population of taxane-resistant cells (they "bred" resistance)...then, you will have to switch to a different agent.

The taxanes are "first line" chemotherapy because they are very effective cancer killers.

The other "first line" drugs for breast cancer are the anthracyclines (AC, FEC...the A in AC is Adriamycin/ Doxorubicin; the E in FEC is Epirubicin...both anthracyclines). The anthracyclines are also very effective cancer killers; however, most people only take them one time (several doses) because they are cardiotoxic.

The taxanes (relatively new) are a breakthrough in chemotherapy because (to my knowledge), they are the only non-anthracycline agents that have been proven to be as effective as the anthracyclines. The bonus is that they are better tolerated by patients long-term because they are not associated with heart damage.

Tammy Lou