Chemotherapy – Antimicrotubule Agents (paclitaxel, vinorelbine, docetaxel, vinblastine)

Antimicrotubule agents are chemotherapy drugs that are used to kill lung cancer (malignant) cells. Antimicrotubule agents block cell growth by stopping mitosis (cell division). As a chemotherapy drug, antimetabolites are a systemic treatment, able to travel throughout the body to kill cancer cells anywhere in the body.1,2 Antimicrotubule agents used for lung cancer treatment include paclitaxel (Taxol®), vinorelbine (Navelbine®), docetaxel (Taxotere®), and vinblastine (Velban®).

Paclitaxel (Taxol®)

Paclitaxel is an anticancer chemotherapy drug that is classified as a plant alkaloid (made from plants), a taxane (made from the bark of the Pacific Yew tree), and as an antimicrotubule agent. Antimicrotubule agents inhibit the microtubules in the cell, which are structures that are critical for cell replication. By inhibiting these structures, paclitaxel causes the cancer cell to die. Paclitaxel is given to the patient through an IV (intravenous) line. Paclitaxel is a chemical that can cause irritation and inflammation of the vein in which it is administered, and patients experiencing any pain, redness, or swelling at the injection site should alert a health care professional immediately. Some patients experience a severe allergic reaction to paclitaxel, and patients are given medications to help prevent this reaction. Paclitaxel is used to treat lung cancer as well as several other cancers. The dosage and schedule of paclitaxel is determined by several factors, such as the patient’s height and weight, general health, and type of cancer.3

Paclitaxel may cause side effects. Common side effects (experienced by greater than 30% of patients taking paclitaxel) include low white blood cells (increasing the risk of infection), low red blood cells (anemia), low platelets (increasing the risk of bleeding), hair loss, pain in the joints or muscles, nausea, vomiting, diarrhea, mouth sores, or a hypersensitivity reaction, including fever, facial flushing, chills, shortness of breath or hives. Less common side effects occurring in 10-29% of patients include swelling of the feet or ankles, increases in liver enzymes on blood tests, low blood pressure during infusion, darkening of the skin where previous radiation therapy has been given, or nail changes.3 Side effects from paclitaxel may be reversible after treatment is finished. This is not a complete list of side effects. Tell your healthcare provider about all conditions, medications, and health history before beginning treatment with paclitaxel.

Vinorelbine (Navelbine®)

Vinorelbine is characterized as a plant alkaloid, a vinca alkaloid (made from the periwinkle plant), and an antimicrotubule agent. Vinorelbine works by inhibiting the microtubules in the cancer cell, causing cell death. Vinorelbine is used to treat non-small cell lung cancer (NSCLC) as well as breast cancer, ovarian cancer, or Hodgkin lymphoma. Vinorelbine is given to the patient through an IV line. Vinorelbine is a chemical that can cause extensive tissue damage and blistering if it escapes the vein, and patients experiencing any pain, redness, or swelling at the injection site should alert a health care professional immediately. The dosage and schedule of vinorelbine is determined by several factors, such as the patient’s height and weight, general health, and type of cancer.3

Vinorelbine may cause side effects. Common side effects (experienced by greater than 30% of patients taking vinorelbine) include low white blood cells (increasing the risk of infection), low red blood cells (anemia), nausea, vomiting, muscle weakness, and constipation. Less common side effects occurring in 10-29% of patients include pain at the site where the medication was given, numbness in fingers and toes, diarrhea, hair loss, and low platelets (increasing the risk of bleeding).3 Side effects from vinorelbine may be reversible after treatment is finished. This is not a complete list of side effects. Tell your healthcare provider about all conditions, medications, and health history before beginning treatment with vinorelbine.

Docetaxel (Taxotere®)

Docetaxel is characterized as a plant alkaloid, a taxane, and an antimicrotubule agent. Docetaxel is used to treat NSCLC as well as breast cancer, advanced stomach cancer, head and neck cancer, and metastatic prostate cancer. Docetaxel is given to the patient through an IV line. Patients may be premedicated (giving medications prior to chemotherapy to prevent a reaction to chemotherapy) with a corticosteroid prior to receiving docetaxel to reduce the severity of side effects such as fluid retention and allergic reactions. The corticosteroid is usually given by mouth the day prior, the day of, and the day after receiving docetaxel. The dosage and schedule of docetaxel is determined by several factors, such as the patient’s height and weight, general health, and type of cancer.3

Docetaxel may cause side effects. Common side effects (experienced by greater than 30% of patients taking docetaxel) include low white blood cells (increasing the risk of infection), low red blood cells (anemia), fluid retention with weight gain, swelling around the ankles or abdominal area, numbness in fingers and toes, nausea, diarrhea, mouth sores, hair loss, fatigue, weakness, infection, and nail changes. Less common side effects occurring in 10-29% of patients include vomiting, muscle pain, bone pain, joint pain, low platelets (increasing the risk of bleeding) and increases in liver enzymes in blood tests. Allergic reactions (rash, flushing, fever, or lowered blood pressure) may also occur, as well as reactions at the site of the infusion (darkening of the vein, inflammation, or redness).3 Side effects from docetaxel may be reversible after treatment is finished. This is not a complete list of side effects. Tell your healthcare provider about all conditions, medications, and health history before beginning treatment with docetaxel.

Vinblastine (Velban®)

Vinblastine is characterized as a plant alkaloid, a vinca alkaloid, and an antimicrotubule agent. Vinblastine works by inhibiting the microtubules in the cancer cell, causing cell death. Vinblastine is used to treat lung cancer as well as several other cancers, including lymphoma, testicular, breast, head and neck, and bladder cancers. Vinblastine is given to the patient through an IV line. As a chemical that can cause extensive tissue damage and blistering if it escapes the vein, patients receiving vinblastine who experience any pain, redness, or swelling at the injection site should alert a health care professional immediately. The dosage and schedule of vinblastine is determined by several factors, such as the patient’s height and weight, general health, and type of cancer.3

Vinblastine may cause side effects. Common side effects (experienced by greater than 30% of patients taking vinblastine) include low white blood cells (increasing the risk of infection), low red blood cells (anemia), low platelets (increasing the risk of bleeding), fatigue, weakness, and injection site reactions. Less common side effects occurring in 10-29% of patients include nausea, vomiting, poor appetite, numbness in fingers and toes, constipation, diarrhea, fever, hair loss, hearing loss, mouth sores, taste changes, headache, depression, jaw or bone pain, high blood pressure, tiredness, and shortness of breath.3 Side effects from vinblastine may be reversible after treatment is finished. This is not a complete list of side effects. Tell your healthcare provider about all conditions, medications, and health history before beginning treatment with vinblastine.

Managing Side Effects

There are many options available to help manage side effects from chemotherapy, and patients should talk to their health care professional about all side effects they experience. Hydration (fluid intake) is very important while receiving chemotherapy, and patients are generally encouraged to drink an adequate amount of fluids every day, which may vary patient to patient. To lower the risk of infection, patients receiving chemotherapy may be advised to avoid crowds, people with colds, and wash their hands often.3

Written by: Emily Downward | Last reviewed: October 2018.
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