Dr. med. Dirk Manski

 You are here: Urology Textbook > Drugs in Urology > Docetaxel

Docetaxel: Chemotherapy of Prostate Cancer

Mechanism of Action of Docetaxel

Docetaxel inhibits intracellular microtubules depolymerization. The stabilization of the tubular structures by docetaxel leads to a cell cycle stop in the G2M phase and to apoptosis.

Indications for Docetaxel

Pharmacokinetics of Docetaxel

Intravenous administration of docetaxel, cytochrome P450-mediated metabolism, Half-life time 11 h, mainly faecal excretion of docetaxel metabolites.

Side Effects of Docetaxel

Haematological side effects:

Neutropenia grade 3–4 in 32%, the nadir is observed after 7 days and lasts 7 days. Neutropenic fever is rare.


Exanthema (maculopapulous) on foot, hand and forearm in 50–70%. Nail toxicity in 35%.

Nervous system:

The occurrence of peripheral sensory neuropathy by docetaxel chemotherapy is frequent and usually reversible. A severe peripheral neuropathy requires a dose reduction of docetaxel and, if there is no improvement, a termination of docetaxel chemotherapy.

Gastrointestinal tract:

The side effects of docetaxel are nausea, vomiting, diarrhea and mucositis.

Further side effects:

Interstitial pneumonia, liver toxicity, lacrimal stenosis. In case of extravasation, severe necrosis must be expected.

Contraindications for Docetaxel:

Patients in poor general condition, previous radionuclide therapy, signs of hepatic failure (bilirubin or liver enzyme elevation over 3.5 times the upper normal limit), creatinine over 2 mg/dl, allergic reaction following docetaxel infusion.

Dose reduction of docetaxel is necessary in case of severe peripheral neuropathy, neutropenia below 1000/μl, thrombopenia below 100000/μl or neutropenic fever (see below). If side effects persist, the treatment should be discontinued. Docetaxel should be paused if neutropenia (below 500/μl) or thrombopenia (below 50000/μl) is present.

Dosage of docetaxel:

Several different regiments of docetaxel are possible. Docetaxel 3-weekly (75 mg/m2) is standard and shows advantages over the weekly dosage (25 mg/m2) in terms of survival (18.9 vs. 17.4 months), pain reduction and tumor responses (12.1 vs. 8.2%) (Tannock et al., 2004). The weekly regime offers a higher safety profile. The 2-weekly regimen (50 mg/m2) was better tolerated in a study with the same efficacy as the 3-weekly regimen (Kellokumpu et al., 2013).


Premedication before docetaxel infusion


Premedication with dexamethasone 8 mg orally, 12 hours, 3 hours and 1 hour before the infusion of docetaxel. Odansetron 8 mg p.o. 2 h before infusion of docetaxel. 5 mg Prednisolone 1-0-1 p.o. for the remaining days of the course.

Docetaxel every 3 weeks:

75   mg / m 2 docetaxel greater than 60   min i.   v. On day 1, cycle duration 21 days.

Docetaxel weekly:

30   mg / m 2 docetaxel greater than 60   min i.   v. On days 1, 8, 15, 22 and 29. Cycle duration 42 days.

Dose reduction of docetaxel:

After the occurrence of severe skin lesions, severe peripheral neuropathy, neutropenia below 1000 / ll, thrombopenia below 100000 / ll, or in neutropenic fever, the dose of docetaxel should be reduced to 60 mg mg / m sup 2 / Sup> for the next dose. For persistent o.g. Symptoms should stop the docetaxel therapy.

Brand Names of Docetaxel


Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z


Kellokumpu-Lehtinen, P.-L.; Harmenberg, U.; Joensuu, T.; McDermott, R.; Hervonen, P.; Ginman, C.; Luukkaa, M.; Nyandoto, P.; Hemminki, A.; Nilsson, S.; McCaffrey, J.; Asola, R.; Turpeenniemi-Hujanen, T.; Laestadius, F.; Tasmuth, T.; Sandberg, K.; Keane, M.; Lehtinen, I.; Luukkaala, T.; Joensuu, H. & , P. R. O. S. T. Y. s. g. 2-Weekly versus 3-weekly docetaxel to treat castration-resistant advanced prostate cancer: a randomised, phase 3 trial.
Lancet Oncol 2013, 14, 117-124

Tannock u.a. 2004 TANNOCK, I. F. ; WIT, R. de ; BERRY, W. R. ; HORTI, J. ; PLUZANSKA, A. ; CHI, K. N. ; OUDARD, S. ; THEODORE, C. ; JAMES, N. D. ; TURESSON, I. ; ROSENTHAL, M. A. ; EISENBERGER, M. A.: Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer.
In: N Engl J Med
351 (2004), Nr. 15, S. 1502–12

  Deutsche Version: Docetaxel