Docetaxel

Advance Directives, Advance Directives, Metastatic Hormone-Refractory Prostate Cancer + 13 more

Treatment

20 FDA approvals

20 Active Studies for Docetaxel

What is Docetaxel

Docetaxel

The Generic name of this drug

Treatment Summary

Docetaxel is a chemotherapy drug used to treat certain types of cancer, such as breast, ovarian, and non-small cell lung cancer. It works by blocking the growth of cancer cells by binding to a protein in them called tubulin.

Taxotere

is the brand name

image of different drug pills on a surface

Docetaxel Overview & Background

Brand Name

Generic Name

First FDA Approval

How many FDA approvals?

Taxotere

Docetaxel

2008

97

Approved as Treatment by the FDA

Docetaxel, also known as Taxotere, is approved by the FDA for 20 uses such as locally advanced untreated non small cell lung cancer and Carcinoma, Non-Small-Cell Lung .

locally advanced untreated non small cell lung cancer

Used to treat locally advanced untreated non small cell lung cancer in combination with Cisplatin

Carcinoma, Non-Small-Cell Lung

Used to treat metastatic untreated non small cell lung cancer in combination with Cisplatin

Neoplasm Metastasis

Metastatic Hormone-Refractory Prostate Cancer

Used to treat refractory, metastatic hormone-refractory Prostate cancer in combination with Prednisone

Node Positive Breast Cancer

Used to treat Node Positive Breast Cancer in combination with Cyclophosphamide

Advance Directives

Used to treat advanced untreated gastric adenocarcinoma in combination with Cisplatin

metastatic untreated non small cell lung cancer

Used to treat metastatic untreated non small cell lung cancer in combination with Cisplatin

Non-Small Cell Lung Carcinoma

Metastatic Breast Cancer

Advance Directives

Ovarian Cancer Metastatic

refractory, metastatic Non small cell lung cancer

refractory, metastatic hormone-refractory Prostate cancer

Used to treat refractory, metastatic hormone-refractory Prostate cancer in combination with Prednisone

Metastatic Squamous Cell Carcinoma of the Head and Neck (HNSCC)

Metastatic Breast Cancer

Squamous Cell Carcinoma of Head and Neck

BRCA1 gene

Malignant Neoplasms

Used to treat Node Positive Breast Cancer in combination with Cyclophosphamide

Advance Directives

Used to treat locally advanced untreated non small cell lung cancer in combination with Cisplatin

Advance Directives

Used to treat locally advanced Squamous cell carcinoma of head and neck in combination with Cisplatin

Effectiveness

How Docetaxel Affects Patients

Docetaxel is a cancer-fighting drug that helps stop cancer cells from growing. It works by forming a stable network of microtubules in the cells, which stops them from reorganizing and performing their normal functions. Docetaxel also causes abnormal clusters of microtubules to form during cell division, which further restricts the cancer cells' growth.

How Docetaxel works in the body

Docetaxel stops cells from functioning properly by making the part of the cell that helps it move, called microtubules, stay in one place. Docetaxel binds to the parts of the microtubules called tubulin, making them unable to shorten or lengthen. This makes it difficult for the cell to move things around, like chromosomes during mitosis. Additionally, docetaxel can make cancer cells die by binding to a protein that stops apoptosis, called Bcl-2.

When to interrupt dosage

The advised dose of Docetaxel depends upon the diagnosed condition, including Esophageal Cancer, Neoplasm Metastasis and Non-Small Cell Lung Carcinoma. The quantity of dosage fluctuates, depending on the approach of administration (e.g. Intravenous or Injection, solution, concentrate - Intravenous) as mentioned in the table below.

Condition

Dosage

Administration

Metastatic Hormone-Refractory Prostate Cancer

20.0 mg/mL, 80.0 mg/mL, , 10.0 mg/mL, 80.0 mg, 20.0 mg, 160.0 mg/mL, 180.0 mg/mL, 120.0 mg/mL, 200.0 mg/mL, 140.0 mg/mL, 40.0 mg/mL, 16.0 mg/mL

Intravenous, Injection, solution, concentrate, Injection, solution, concentrate - Intravenous, , Kit, Injection, solution - Intravenous, Injection, solution, Injection - Intravenous, Injection, Solution - Intravenous, Solution, Kit; Solution, Kit; Solution - Intravenous

Malignant Neoplasms

20.0 mg/mL, 80.0 mg/mL, , 10.0 mg/mL, 80.0 mg, 20.0 mg, 160.0 mg/mL, 180.0 mg/mL, 120.0 mg/mL, 200.0 mg/mL, 140.0 mg/mL, 40.0 mg/mL, 16.0 mg/mL

Intravenous, Injection, solution, concentrate, Injection, solution, concentrate - Intravenous, , Kit, Injection, solution - Intravenous, Injection, solution, Injection - Intravenous, Injection, Solution - Intravenous, Solution, Kit; Solution, Kit; Solution - Intravenous

Small Cell Lung Cancer

20.0 mg/mL, 80.0 mg/mL, , 10.0 mg/mL, 80.0 mg, 20.0 mg, 160.0 mg/mL, 180.0 mg/mL, 120.0 mg/mL, 200.0 mg/mL, 140.0 mg/mL, 40.0 mg/mL, 16.0 mg/mL

Intravenous, Injection, solution, concentrate, Injection, solution, concentrate - Intravenous, , Kit, Injection, solution - Intravenous, Injection, solution, Injection - Intravenous, Injection, Solution - Intravenous, Solution, Kit; Solution, Kit; Solution - Intravenous

Urinary Bladder Neoplasms

20.0 mg/mL, 80.0 mg/mL, , 10.0 mg/mL, 80.0 mg, 20.0 mg, 160.0 mg/mL, 180.0 mg/mL, 120.0 mg/mL, 200.0 mg/mL, 140.0 mg/mL, 40.0 mg/mL, 16.0 mg/mL

Intravenous, Injection, solution, concentrate, Injection, solution, concentrate - Intravenous, , Kit, Injection, solution - Intravenous, Injection, solution, Injection - Intravenous, Injection, Solution - Intravenous, Solution, Kit; Solution, Kit; Solution - Intravenous

Soft Tissue Sarcoma

20.0 mg/mL, 80.0 mg/mL, , 10.0 mg/mL, 80.0 mg, 20.0 mg, 160.0 mg/mL, 180.0 mg/mL, 120.0 mg/mL, 200.0 mg/mL, 140.0 mg/mL, 40.0 mg/mL, 16.0 mg/mL

Intravenous, Injection, solution, concentrate, Injection, solution, concentrate - Intravenous, , Kit, Injection, solution - Intravenous, Injection, solution, Injection - Intravenous, Injection, Solution - Intravenous, Solution, Kit; Solution, Kit; Solution - Intravenous

Neoplasm Metastasis

20.0 mg/mL, 80.0 mg/mL, , 10.0 mg/mL, 80.0 mg, 20.0 mg, 160.0 mg/mL, 180.0 mg/mL, 120.0 mg/mL, 200.0 mg/mL, 140.0 mg/mL, 40.0 mg/mL, 16.0 mg/mL

Intravenous, Injection, solution, concentrate, Injection, solution, concentrate - Intravenous, , Kit, Injection, solution - Intravenous, Injection, solution, Injection - Intravenous, Injection, Solution - Intravenous, Solution, Kit; Solution, Kit; Solution - Intravenous

Squamous Cell Carcinoma of Head and Neck

20.0 mg/mL, 80.0 mg/mL, , 10.0 mg/mL, 80.0 mg, 20.0 mg, 160.0 mg/mL, 180.0 mg/mL, 120.0 mg/mL, 200.0 mg/mL, 140.0 mg/mL, 40.0 mg/mL, 16.0 mg/mL

Intravenous, Injection, solution, concentrate, Injection, solution, concentrate - Intravenous, , Kit, Injection, solution - Intravenous, Injection, solution, Injection - Intravenous, Injection, Solution - Intravenous, Solution, Kit; Solution, Kit; Solution - Intravenous

Advance Directives

20.0 mg/mL, 80.0 mg/mL, , 10.0 mg/mL, 80.0 mg, 20.0 mg, 160.0 mg/mL, 180.0 mg/mL, 120.0 mg/mL, 200.0 mg/mL, 140.0 mg/mL, 40.0 mg/mL, 16.0 mg/mL

Intravenous, Injection, solution, concentrate, Injection, solution, concentrate - Intravenous, , Kit, Injection, solution - Intravenous, Injection, solution, Injection - Intravenous, Injection, Solution - Intravenous, Solution, Kit; Solution, Kit; Solution - Intravenous

Advance Directives

20.0 mg/mL, 80.0 mg/mL, , 10.0 mg/mL, 80.0 mg, 20.0 mg, 160.0 mg/mL, 180.0 mg/mL, 120.0 mg/mL, 200.0 mg/mL, 140.0 mg/mL, 40.0 mg/mL, 16.0 mg/mL

Intravenous, Injection, solution, concentrate, Injection, solution, concentrate - Intravenous, , Kit, Injection, solution - Intravenous, Injection, solution, Injection - Intravenous, Injection, Solution - Intravenous, Solution, Kit; Solution, Kit; Solution - Intravenous

Advance Directives

20.0 mg/mL, 80.0 mg/mL, , 10.0 mg/mL, 80.0 mg, 20.0 mg, 160.0 mg/mL, 180.0 mg/mL, 120.0 mg/mL, 200.0 mg/mL, 140.0 mg/mL, 40.0 mg/mL, 16.0 mg/mL

Intravenous, Injection, solution, concentrate, Injection, solution, concentrate - Intravenous, , Kit, Injection, solution - Intravenous, Injection, solution, Injection - Intravenous, Injection, Solution - Intravenous, Solution, Kit; Solution, Kit; Solution - Intravenous

Non-Small Cell Lung Carcinoma

20.0 mg/mL, 80.0 mg/mL, , 10.0 mg/mL, 80.0 mg, 20.0 mg, 160.0 mg/mL, 180.0 mg/mL, 120.0 mg/mL, 200.0 mg/mL, 140.0 mg/mL, 40.0 mg/mL, 16.0 mg/mL

Intravenous, Injection, solution, concentrate, Injection, solution, concentrate - Intravenous, , Kit, Injection, solution - Intravenous, Injection, solution, Injection - Intravenous, Injection, Solution - Intravenous, Solution, Kit; Solution, Kit; Solution - Intravenous

Sarcoma

20.0 mg/mL, 80.0 mg/mL, , 10.0 mg/mL, 80.0 mg, 20.0 mg, 160.0 mg/mL, 180.0 mg/mL, 120.0 mg/mL, 200.0 mg/mL, 140.0 mg/mL, 40.0 mg/mL, 16.0 mg/mL

Intravenous, Injection, solution, concentrate, Injection, solution, concentrate - Intravenous, , Kit, Injection, solution - Intravenous, Injection, solution, Injection - Intravenous, Injection, Solution - Intravenous, Solution, Kit; Solution, Kit; Solution - Intravenous

BRCA1 gene

20.0 mg/mL, 80.0 mg/mL, , 10.0 mg/mL, 80.0 mg, 20.0 mg, 160.0 mg/mL, 180.0 mg/mL, 120.0 mg/mL, 200.0 mg/mL, 140.0 mg/mL, 40.0 mg/mL, 16.0 mg/mL

Intravenous, Injection, solution, concentrate, Injection, solution, concentrate - Intravenous, , Kit, Injection, solution - Intravenous, Injection, solution, Injection - Intravenous, Injection, Solution - Intravenous, Solution, Kit; Solution, Kit; Solution - Intravenous

Advance Directives

20.0 mg/mL, 80.0 mg/mL, , 10.0 mg/mL, 80.0 mg, 20.0 mg, 160.0 mg/mL, 180.0 mg/mL, 120.0 mg/mL, 200.0 mg/mL, 140.0 mg/mL, 40.0 mg/mL, 16.0 mg/mL

Intravenous, Injection, solution, concentrate, Injection, solution, concentrate - Intravenous, , Kit, Injection, solution - Intravenous, Injection, solution, Injection - Intravenous, Injection, Solution - Intravenous, Solution, Kit; Solution, Kit; Solution - Intravenous

Metastatic Breast Cancer

20.0 mg/mL, 80.0 mg/mL, , 10.0 mg/mL, 80.0 mg, 20.0 mg, 160.0 mg/mL, 180.0 mg/mL, 120.0 mg/mL, 200.0 mg/mL, 140.0 mg/mL, 40.0 mg/mL, 16.0 mg/mL

Intravenous, Injection, solution, concentrate, Injection, solution, concentrate - Intravenous, , Kit, Injection, solution - Intravenous, Injection, solution, Injection - Intravenous, Injection, Solution - Intravenous, Solution, Kit; Solution, Kit; Solution - Intravenous

Carcinoma, Non-Small-Cell Lung

20.0 mg/mL, 80.0 mg/mL, , 10.0 mg/mL, 80.0 mg, 20.0 mg, 160.0 mg/mL, 180.0 mg/mL, 120.0 mg/mL, 200.0 mg/mL, 140.0 mg/mL, 40.0 mg/mL, 16.0 mg/mL

Intravenous, Injection, solution, concentrate, Injection, solution, concentrate - Intravenous, , Kit, Injection, solution - Intravenous, Injection, solution, Injection - Intravenous, Injection, Solution - Intravenous, Solution, Kit; Solution, Kit; Solution - Intravenous

Warnings

Docetaxel Contraindications

Condition

Risk Level

Notes

neutrophil count <1500 cells/mm3

Do Not Combine

There are 20 known major drug interactions with Docetaxel.

Common Docetaxel Drug Interactions

Drug Name

Risk Level

Description

2-Methoxyethanol

Major

The risk or severity of adverse effects can be increased when Docetaxel is combined with 2-Methoxyethanol.

9-(N-methyl-L-isoleucine)-cyclosporin A

Major

The risk or severity of adverse effects can be increased when Docetaxel is combined with 9-(N-methyl-L-isoleucine)-cyclosporin A.

Abemaciclib

Major

The metabolism of Abemaciclib can be decreased when combined with Docetaxel.

Abetimus

Major

The risk or severity of adverse effects can be increased when Docetaxel is combined with Abetimus.

Acteoside

Major

The risk or severity of adverse effects can be increased when Docetaxel is combined with Acteoside.

Docetaxel Toxicity & Overdose Risk

The lowest toxic dose of this drug in rats is greater than 2000 mg/kg. Symptoms of overdose can include a decrease in the number of white blood cells, nerve damage, and inflammation of the lining of the digestive tract. In two cases of overdose, one patient received 150 mg/m2 and the other received 200 mg/m2 as 1-hour infusions. Both suffered from low white blood cell count, weakness, skin reactions, and pins and needles sensations. Thankfully they both recovered without any long-term effects.

image of a doctor in a lab doing drug, clinical research

Docetaxel Novel Uses: Which Conditions Have a Clinical Trial Featuring Docetaxel?

Currently, 378 active studies are evaluating the potential of Docetaxel to treat metastatic untreated non-small cell lung cancer, Sarcoma and Advance Directives.

Condition

Clinical Trials

Trial Phases

Metastatic Hormone-Refractory Prostate Cancer

79 Actively Recruiting

Phase 1, Phase 2, Not Applicable, Phase 4, Phase 3, Early Phase 1

Metastatic Breast Cancer

1 Actively Recruiting

Phase 1, Phase 2

BRCA1 gene

12 Actively Recruiting

Phase 2, Not Applicable, Phase 1, Early Phase 1, Phase 3

Non-Small Cell Lung Carcinoma

714 Actively Recruiting

Not Applicable, Phase 2, Phase 1, Phase 3, Phase 4, Early Phase 1

Advance Directives

0 Actively Recruiting

Small Cell Lung Cancer

50 Actively Recruiting

Phase 2, Phase 3, Phase 1, Not Applicable, Early Phase 1

Advance Directives

0 Actively Recruiting

Carcinoma, Non-Small-Cell Lung

0 Actively Recruiting

Neoplasm Metastasis

1 Actively Recruiting

Phase 2

Soft Tissue Sarcoma

51 Actively Recruiting

Phase 2, Not Applicable, Phase 1, Phase 4, Early Phase 1, Phase 3

Advance Directives

0 Actively Recruiting

Squamous Cell Carcinoma of Head and Neck

6 Actively Recruiting

Phase 1, Phase 2, Phase 3

Sarcoma

1 Actively Recruiting

Phase 2

Advance Directives

0 Actively Recruiting

Malignant Neoplasms

4 Actively Recruiting

Not Applicable, Phase 2

Urinary Bladder Neoplasms

0 Actively Recruiting

Docetaxel Reviews: What are patients saying about Docetaxel?

5

Patient Review

3/20/2010

Docetaxel for Non-Small Cell Lung Cancer

Today was my first time using this treatment, and I thought it was great!

4.3

Patient Review

8/7/2009

Docetaxel for Non-Small Cell Lung Cancer

So far, this has been working well for me with no noticeable side effects like nausea or vomiting. I'm on my third treatment--taking it once a week--and also doing radiation therapy five days a week.

4

Patient Review

9/12/2012

Docetaxel for Breast Cancer that has Spread to Another Part of the Body

This treatment was successful in reducing the size of my tumors and the amount of pleural fluid in my lungs. I now have an improved quality of life and breath much better than before.

4

Patient Review

11/29/2012

Docetaxel for Cancer of Prostate that has Spread to Other Part of Body

Taxatere was successful for me for three years, but my PSA levels began to rise again. I am now on docetaxel and this is my third treatment. I am hoping and praying that this will be successful for another three years.

2.7

Patient Review

1/21/2010

Docetaxel for Cancer of Prostate that has Spread to Other Part of Body

I've been taking this medication for 25 months, and I'm starting to see serious adverse effects. These include issues with my taste buds, fatigue, skin bruising, and nails as well as recurrent cancer growth. I don't think the benefits are worth the risks anymore.

2

Patient Review

1/13/2012

Docetaxel for Breast Cancer that has Spread to Another Part of the Body

It caused my feet and hands to burn, and I lost my finger- and toenails.

2

Patient Review

6/23/2010

Docetaxel for Breast Cancer

The tumor has shrunk, but I now have immense muscle pain all over my body.

1.3

Patient Review

12/16/2008

Docetaxel for Non-Small Cell Lung Cancer

My mother was just diagnosed with stage 4 non small cell lung cancer a week ago after emergency surgery. She had no previous signs or symptoms of the disease.
image of drug pills surrounding a glass of water symbolizing drug consumption

Patient Q&A Section about docetaxel

These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

What is the most common side effect of docetaxel?

"The two most common long-term side effects of docetaxel chemotherapy are sensory and motor peripheral neuropathy, which are fortunately much less common than with paclitaxel. Grade 3 and 4 neuropathy is only observed in less than 10% of patients receiving docetaxel therapy."

Answered by AI

What is the docetaxel used for?

"Docetaxel injection is used to treat patients with advanced or metastatic breast cancer who have previously received other cancer medicines that were ineffective."

Answered by AI

What is the success rate of docetaxel?

"Docetaxel combined with another antineoplastic resulted in a 20-54% objective response rate for chemotherapy-naive patients. Triple chemotherapy combinations resulted in a 51-60% response rate for patients."

Answered by AI

Is docetaxel a strong chemotherapy?

"Since docetaxel is a potent chemotherapeutic agent, it produces numerous side effects. The most common ones are nausea, vomiting, and hair loss."

Answered by AI

Clinical Trials for Docetaxel

Image of Henry Ford Cancer- Detroit in Detroit, United States.

SG + Immunotherapy for Lung Cancer

18+
All Sexes
Detroit, MI

The goal of this clinical trial is to learn if the combination of sacituzumab govetican (SG) and atezolizumab/durvalumab is effective in controlling cancer tumor growth in adults with extensive stage small cell lung cancer. These drugs are FDA approved individually in different cancers. This combination is evaluated in breast cancer and showed promising combination. The effectiveness of this treatment combination will be measured by changes in tumor size and appearance of new tumors. Participants in the trial will: * receive treatment SG and immunotherapy every 21 days for up to 2 years or until it is no longer works for the patient. * CT scans at 6weeks for first 6 cycles and then every 9-12 weeks and MRI brain every 12 weeks. * provide tissue (optional) and blood for additional testing (learn about the cancer).

Phase 2
Waitlist Available

Henry Ford Cancer- Detroit

Gilead Sciences

Image of University of North Carolina in Chapel Hill, United States.

Pembrolizumab and Radiation for Triple Negative Breast Cancer

18+
All Sexes
Chapel Hill, NC

This is a prospective radiation dose-finding, phase 2 expansion study of the Triple Negative (TN) cohort of the multicenter randomized study P-RAD (A Randomized Study of Preoperative Chemotherapy, Pembrolizumab and No, Low or High Dose RADiation in Node-Positive, HER2-Negative Breast Cancer; NCT04443348) that seeks to establish the optimal dose of radiation therapy (RT) to elicit an immune response when combined with immune checkpoint inhibitor (ICI) in breast cancer patients. Eligible subjects include women or men with operable, lymph node-positive, triple negative (TN) breast cancer who are candidates for standard of care neoadjuvant chemo-immunotherapy (NAC) based on the KEYNOTE-522 clinical trial. Thirty-two (n=32) patients will be randomized 1:1 to receive either low RT boost (9Gy total) or high RT boost (24Gy total). All RT will be delivered to the intact breast tumor in 3 daily fractions over 3 days. In the Neoadjuvant Phase, the first cycle (C1) of pembrolizumab (200 mg i.v.) will be administered within 0-2 days of initiating RT. Participation in this study requires availability of residual diagnostic tissue biopsies of the primary tumor and metastatic lymph node for research use. If this tissue is not available, baseline research biopsies will be performed. Additionally, a research biopsy of the breast tumor and lymph node is required on Day 10-14 of C1 of pembrolizumab. After completion of the research biopsy in Week 2, the participants can commence standard-of-care neoadjuvant chemotherapy and pembrolizumab at the discretion of their medical oncology provider. After completing NAC, participants will undergo standard of care surgical resection of the breast and axillary lymph nodes, at the discretion of their surgical oncology provider. In the Adjuvant Phase, participants will receive standard of care adjuvant systemic therapy and standard of care adjuvant radiotherapy (if indicated), although recognizing that the breast tumor boost portion of this treatment has already been administered preoperatively. Except for late radiation adverse reactions of special interest, which will be followed yearly for up to 5 years, follow-up will occur every 6 months for 3 years.

Phase 2
Waitlist Available

University of North Carolina

Dana Casey, MD

Merck Sharp & Dohme LLC

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Image of The Ottawa Hospital Cancer Centre in Ottawa, Canada.

Endocrine Therapy for Breast and Prostate Cancer

18+
All Sexes
Ottawa, Canada

The REaCT-CHRONO-MetBP Pilot study will compare morning and evening administration of endocrine-based therapy in metastatic breast and prostate cancers. Participants with metastatic breast or prostate cancer will be randomly placed in one of two groups: a morning group and an evening group. The group assignment will determine whether they take their endocrine therapy in the morning or the evening. The primary outcome of this pilot study is to evaluate the feasibility of study procedures in order to conduct a larger definitive trial in the future. The secondary outcomes include comparing quality of life, tolerability, and efficacy outcomes between the morning and evening groups for each of the two cancer cohorts (metastatic breast and prostate cancer).

Phase 4
Waitlist Available

The Ottawa Hospital Cancer Centre

Marie-France Savard, MD

Image of Washington University School of Medicine in St Louis, United States.

Cirtuvivint + Irinotecan for Small Cell Lung Cancer

18+
All Sexes
St Louis, MO

Although small cell lung cancer (SCLC) responds dramatically to initial platinum-based chemotherapy, recurrences are nearly universal. The addition of atezolizumab, an immune checkpoint inhibitor, to front-line chemotherapy has recently demonstrated an improvement in overall survival (OS) in extensive stage SCLC (ES-SCLC). Subsequent lines of therapies are associated with modest efficacy in patients with relapsed disease, and the median overall survival is still 12 to 13 months at best. Cirtuvivint is a small molecule inhibitor of the CDC2-like kinases (CLKs) and dual-specificity tyrosine-regulated kinases (DYRKs); inhibiting CLKs and DYRKs has been shown in preclinical models to cause tumor growth inhibition and sensitize cancer cells to cytotoxic chemotherapy. This study is testing the hypothesis that adding cirtuvivint to chemotherapy in patients with relapsed SCLC will be well tolerated and improve the response rate and progression-free survival (PFS).

Phase 1 & 2
Recruiting

Washington University School of Medicine

Ramaswamy Govindan, M.D.

Biosplice Therapeutics, Inc.

Have you considered Docetaxel clinical trials?

We made a collection of clinical trials featuring Docetaxel, we think they might fit your search criteria.
Go to Trials

Have you considered Docetaxel clinical trials?

We made a collection of clinical trials featuring Docetaxel, we think they might fit your search criteria.
Go to Trials