Paclitaxel, cisplatin and gemcitabine in treatment of carcinomas of unknown primary site, a phase II study

• Published in: Acta oncologica 2010-05, Vol.49 (4), p.423-430
• Main Authors: Møller, Anne Kirstine Hundahl, Pedersen, Karen Damgaard, Gothelf, Anita, Daugaard, Gedske
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antimetabolites, Antineoplastic - administration & dosage; Antineoplastic Agents, Phytogenic - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bone Marrow - drug effects; Bone Neoplasms - drug therapy; Bone Neoplasms - secondary; Cisplatin - administration & dosage; Deoxycytidine - administration & dosage; Deoxycytidine - analogs & derivatives; Disease-Free Survival; Female; Humans; Kaplan-Meier Estimate; Liver Neoplasms - drug therapy; Liver Neoplasms - secondary; Lung Neoplasms - drug therapy; Lung Neoplasms - secondary; Lymphatic Metastasis; Male; Middle Aged; Neoplasms, Unknown Primary - drug therapy; Paclitaxel - administration & dosage; Risk Factors; Treatment Outcome
• ISSN: 0284-186X; 1651-226X
• DOI: 10.3109/02841860903544592

Abstract Background. The present study was conducted to evaluate the efficacy and toxicity of a combination of paclitaxel, cisplatin and gemcitabine in patients with carcinoma of unknown primary site (CUP). Patients and methods. Patients with CUP, ECOG performance status 0-1 and age between 18 and 65 years old were treated with paclitaxel 175 mg/m2 day 1, cisplatin 75 mg/m2 day 1 and gemcitabine 1000 mg/m2 day 1 and 8 in a three-week schedule. Results. Ninety-eight patients were enrolled between 1998 and 2008. Ninety-one patients had target lesions according to the RECIST guidelines. The overall response rate was 42.9% (39 patients), including five complete responses (5.5%) and 34 partial responses (37.4%). The median survival time was 10.7 months, and the survival rates at one and two years were 42% and 14%, respectively. The most frequent grade 3 or more adverse events were neutropenia and thrombocytopenia. There were 3 treatment-related deaths. Conclusions. Combination of paclitaxel, cisplatin and gemcitabine is an active regimen in patients with CUP with response and survival rates at least similar to other platinum- and taxane-containing regimens. The treatment was well tolerated by most patients although neutropenia and thrombocytopenia were relatively common. The present regimen represents an attractive regimen in younger CUP patients with a good performance status.