Pharmacogenetics, enzyme probes and therapeutic drug monitoring as potential tools for individualizing taxane therapy

Pharmacogenomics. 2013 Apr;14(5):555-74. doi: 10.2217/pgs.13.33.


The taxanes are a class of chemotherapeutic agents that are widely used in the treatment of various solid tumors. Although taxanes are highly effective in cancer treatment, their use is associated with serious complications attributable to large interindividual variability in pharmacokinetics and a narrow therapeutic window. Unpredictable toxicity occurrence necessitates close patient monitoring while on therapy and adverse effects frequently require decreasing, delaying or even discontinuing taxane treatment. Currently, taxane dosing is based primarily on body surface area, ignoring other factors that are known to dictate variability in pharmacokinetics or outcome. This article discusses three potential strategies for individualizing taxane treatment based on patient information that can be collected before or during care. The clinical implementation of pharmacogenetics, enzyme probes or therapeutic drug monitoring could enable clinicians to personalize taxane treatment to enhance efficacy and/or limit toxicity.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / metabolism
  • Antineoplastic Agents / pharmacokinetics
  • Antineoplastic Agents / therapeutic use
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / enzymology
  • Breast Neoplasms / genetics*
  • Bridged-Ring Compounds / metabolism*
  • Bridged-Ring Compounds / pharmacokinetics
  • Bridged-Ring Compounds / therapeutic use
  • Docetaxel
  • Drug Monitoring*
  • Female
  • Humans
  • Neoplasms / drug therapy
  • Neoplasms / enzymology
  • Neoplasms / genetics
  • Paclitaxel / metabolism
  • Paclitaxel / pharmacokinetics
  • Paclitaxel / therapeutic use
  • Pharmacogenetics*
  • Precision Medicine
  • Taxoids / metabolism*
  • Taxoids / pharmacokinetics
  • Taxoids / therapeutic use


  • Antineoplastic Agents
  • Bridged-Ring Compounds
  • Taxoids
  • Docetaxel
  • taxane
  • Paclitaxel