ISSN:
1569-8041
Keywords:
docetaxel in unknown primary
;
therapy of unknown primary cancer
;
unknown primary cancer
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Purpose:To evaluate the toxicity, response rate and short-termsurvival associated with the chemotherapy combinations of docetaxel pluscisplatin or carboplatin when used for the treatment of patients withmetastatic carcinoma of unknown primary site. Patients and methods:Twenty-six patients were treated withdocetaxel 75 mg/m2 i.v. and cisplatin 75 mg/m2 i.v.given every three weeks (study A) and subsequently, 47 patients were treatedwith docetaxel 65 mg/m2 and carboplatin (AUC dose = 6) every threeweeks (study B). Stable or responding patients received a maximum of eightcourses of therapy. Patients who were known to be in treatable subset groupswere excluded from these trials. The majority of patients had two or moresites of metastasis; about 45% had adenocarcinoma and 50% poorlydifferentiated carcinoma. Results:In study A, 6 of 23 (26%) assessable patients hada major response to therapy. The median survival was eight months and one-yearsurvival 42%. Seven patients were removed from the study early forgrade 3 or 4 nausea and vomiting. In study B, 9 of 40 assessable patients(22%) had a major response to therapy. Median survival was eight monthsand one-year survival 29%. Toxicity associated with this regimen waspredominantly myelosuppression. Comparisons of the two sequential trialsshowed no differences in response rates or survivals (P = 0.75). Conclusions:Docetaxel and cisplatin (study A) is an activecombination in carcinoma of unknown primary site, but associated withsubstantial gastrointestinal toxicity. A combination of docetaxel pluscarboplatin (study B) is better tolerated and produced a similar responserate, median survival and one-year survival. Comparative phase III trials willbe necessary to unequivically prove a survival advantage for any form oftherapy in these patients. However, the survival for patients with carcinomaof unknown primary site receiving docetaxel-based chemotherapy is comparableto the survivals for several other groups of advanced cancer patients, suchas non-small cell lung cancer, receiving various types of chemotherapy.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008369812295
Permalink