Capecitabine and oxaliplatin as second-line treatment in patients with carcinoma of unknown primary site

• Published in: Acta oncologica 2010-05, Vol.49 (4), p.431-435
• Main Authors: Møller, Anne Kirstine Hundahl, Pedersen, Karen Damgaard, Abildgaard, Julie, Petersen, Bodil Laub, Daugaard, Gedske
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antimetabolites, Antineoplastic - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Capecitabine; Carcinoma - drug therapy; Deoxycytidine - administration & dosage; Deoxycytidine - analogs & derivatives; Disease-Free Survival; Female; Fluorouracil - administration & dosage; Fluorouracil - analogs & derivatives; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Neoplasms, Unknown Primary - drug therapy; Organoplatinum Compounds - administration & dosage; Salvage Therapy - methods; Treatment Outcome
• ISSN: 0284-186X; 1651-226X
• DOI: 10.3109/02841861003649240

Abstract Background. Treatment of patients with carcinoma of unknown primary site (CUP) remains a challenge, and no effective second-line treatment has been identified. In CUP patients who are non-responsive or relapse early after first-line platinum/taxane-based regimens, it is likely that gastrointestinal (GI) tract tumours may be overrepresented. These patients could be candidates for GI tract-directed therapy. We here report the results obtained with oxaliplatin and capecitabine as second-line therapy in 25 recurrent/refractory CUP patients following first-line treatment with paclitaxel, cisplatin and gemcitabine. Patients and methods. Patients received capecitabine orally (1000 mg/m2) twice daily, days 1-14, and oxaliplatin (130 mg/m2) intravenously on day 1 in a three-week schedule. Results. Twenty-five CUP patients received a median of three cycles of capecitabine and oxaliplatin as second-line treatment. Histopathological assessments suggested the primary site to be of GI tract origin in the majority of the patients (76%). We found an objective response rate of 13%, a median progression-free survival and overall survival rate of 2.3 and 3.9 months, respectively, and 32% of patients alive at one year after initiation of second-line therapy. The regimen was well tolerated by most patients. Conclusions. This study, demonstrates that there is still a significant need for improved second-line therapy in CUP patients.