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Weekly Paclitaxel — SCE Medical Oncology MCQ

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ModerateGynaecological CancersWeekly PaclitaxelSCE Medical Oncology

A 58-year-old woman with recurrent platinum-resistant ovarian cancer is offered weekly paclitaxel. She previously received 3-weekly paclitaxel as first-line. Is there a schedule advantage?

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Correct answer: CWeekly paclitaxel has a different anti-tumour mechanism with improved tolerability compared with 3-weekly dosing

Weekly paclitaxel (80 mg/m²) has a dual mechanism: cytotoxic (microtubule stabilisation) plus anti-angiogenic (metronomic scheduling). JGOG 3016 showed OS benefit for weekly vs 3-weekly paclitaxel in advanced ovarian cancer first-line. Weekly scheduling has better tolerability: less grade 3-4 neutropenia (~2% vs ~73%) and less neuropathy, though more frequent clinic visits. In platinum-resistant disease, weekly paclitaxel ± bevacizumab (AURELIA) is the standard approach.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer