Background/Objectives: Paclitaxel is a type of small molecule chemotherapy widely used for breast cancer, but its clinical efficacy is often hindered by dose-limiting toxicities such as chemotherapy-induced peripheral neuropathy and neutropenia. Traditional dosing based on body surface area does not account for variations in body composition, which may influence paclitaxel metabolism, toxicity, and treatment outcomes. This review explores the interplay between body composition, physical activity, and paclitaxel pharmacokinetics, emphasizing the potential for personalized dosing strategies. Methods: A comprehensive narrative review was conducted by analyzing the literature on body composition, small molecule chemotherapy-related toxicities, pharmacokinetics, and exercise oncology. Studies examining the role of skeletal muscle mass, adipose tissue, and physical activity in modulating paclitaxel metabolism and side effects were included. Results: Evidence suggests that patients with low skeletal muscle mass are at a higher risk of paclitaxel-induced toxicities due to altered drug distribution and clearance. Sarcopenic obesity, characterized by low muscle and high-fat levels, further exacerbates these risks. Exercise, particularly resistance and aerobic training, has been shown to improve muscle mass, mitigate toxicities, and enhance chemotherapy tolerance. However, the precise mechanisms by which exercise influences paclitaxel pharmacokinetics remain underexplored. Conclusions: Personalized chemotherapy dosing, considering body composition and physical activity, may optimize paclitaxel treatment outcomes. Future research should focus on integrating exercise interventions into oncology care and refining dosing models that account for interindividual differences in drug metabolism. These advancements could improve treatment efficacy while minimizing toxicities in breast cancer patients.
**背景/目的：** 紫杉醇是一种广泛用于乳腺癌治疗的小分子化疗药物，但其临床疗效常因剂量限制性毒性（如化疗诱导的周围神经病变和中性粒细胞减少症）而受限。基于体表面积的传统给药方式未考虑身体成分的差异，而后者可能影响紫杉醇的代谢、毒性及治疗结局。本综述探讨了身体成分、体力活动与紫杉醇药代动力学之间的相互作用，并强调了个体化给药策略的潜力。 **方法：** 通过分析有关身体成分、小分子化疗药物相关毒性、药代动力学及运动肿瘤学的文献，进行了一项全面的叙述性综述。纳入的研究探讨了骨骼肌质量、脂肪组织及体力活动在调节紫杉醇代谢和副作用中的作用。 **结果：** 证据表明，骨骼肌质量低的患者因药物分布和清除的改变，面临更高的紫杉醇诱导毒性风险。以低肌肉量和高脂肪水平为特征的肌肉减少性肥胖进一步加剧了这些风险。运动，特别是抗阻和有氧训练，已被证明能增加肌肉质量、减轻毒性并提高化疗耐受性。然而，运动影响紫杉醇药代动力学的具体机制仍未得到充分探索。 **结论：** 考虑身体成分和体力活动的个体化化疗给药方案，可能优化紫杉醇的治疗效果。未来研究应侧重于将运动干预整合到肿瘤治疗中，并完善能解释个体间药物代谢差异的给药模型。这些进展有望在提高疗效的同时，最大限度地减少乳腺癌患者的毒性反应。
肿瘤(癌症)患者之家