Taxol, the brand name of the chemotherapy drug paclitaxel, has been used to treat cancer since its approval by the FDA in 1992. The drug’s active ingredient is derived from the bark of the Pacific yew, a tree native to the Pacific Northwest. It was first harvested and tested for its medicinal properties in 1962. Given paclitaxel’s success in treating many different cancers, it is now being studied to treat malignant pleural mesothelioma. 

Paclitaxel’s Success in Treating Other Cancers

Paclitaxel is available in two formulations. The conventional formulation successfully treats many other cancers, including 

  • Anal cancer
  • Bladder cancer
  • Breast cancer
  • Cervical cancer
  • Endometrial cancer
  • Esophageal cancer
  • Gastric cancer
  • Head and neck cancer
  • Kaposi sarcoma
  • Melanoma
  • Non-small cell lung cancer
  • Ovarian cancer
  • Penile cancer
  • Small cell lung cancer
  • Soft tissue sarcoma 
  • Testicular germ cell tumors
  • Thymic carcinoma
  • Thyroid cancer

The nanoparticle formulation, known as nab-paclitaxel, successfully treats 

  • Breast cancer 
  • Non-small cell lung cancer
  • Pancreatic cancer

Paclitaxel is commonly used in a multimodal approach, meaning it is combined with other chemotherapy drugs, like carboplatin and cisplatin, and other cancer therapies such as surgery and radiation. Combination treatment generally leads to better outcomes than what can be achieved with one drug or one kind of cancer therapy alone.

Learning from Prior Research

Paclitaxel was first studied to treat malignant pleural mesothelioma in the 1990s. However, it was only studied as a monotherapy, meaning it was not given in combination with other therapies.1 As we now know, such an approach is rarely successful in treating any cancer, let alone one as hard to treat as malignant pleural mesothelioma. 

How Paclitaxel Works

Paclitaxel works to inhibit the replication of a cell’s genetic material. This inhibition of DNA replication helps keep in check the uncontrollable proliferation of cancer cells. Paclitaxel may also affect the body’s immune response so that the immune system can more effectively fight and kill cancer cells.

Nab-Paclitaxel for the Treatment of Mesothelioma

Researchers are currently studying nab-paclitaxel in mice for its potential to treat malignant pleural mesothelioma in people. Nab-paclitaxel has been used to treat many other cancers. It uses a nanoparticle drug delivery system to deliver paclitaxel to cancerous tissues in a way that optimizes the drug’s efficacy and decreases its side effects.

Nab-paclitaxel has been found to prolong survival in mice with limited disease, and when combined with cytoreductive surgery, it has been found to prolong survival in mice with advanced disease, too. If these results can be successfully replicated in people and are found to be significant, nab-paclitaxel could become a new treatment option for malignant pleural mesothelioma.

Side Effects of Paclitaxel and Nab-Paclitaxel

Common side effects of paclitaxel include 

  • Low blood counts (white blood cells, healthy red blood cells, and platelets)
  • Elevated liver enzymes 
  • Infection
  • Numbness and tingling 
  • Nerve pain
  • Weakness
  • Heart rate and rhythm abnormalities
  • Low blood pressure
  • Inflammed and sore mouth
  • Hair loss
  • Swelling
  • Flushing
  • Nausea
  • Vomiting
  • Diarrhea
  • Joint ache
  • Muscle ache 
  • Fever
  • Allergic reaction
  • Skin rash 

Common side effects of nab-paclitaxel include less severe forms of some of the above side effects as well as possible side effects of

  • Shortness of breath
  • Cough
  • Dehydration 
  • Low potassium
  • Decreased kidney function
  • Constipation
  • Urinary tract infection
  • Altered senses of taste and sight
  • Decreased appetite 
  • Nosebleed
  • Fatigue
  • Headache
  • Depression2