Docetaxel and carboplatin combination chemotherapy as outpatient palliative therapy in carcinoma of unknown primary: A multicentre Hellenic Cooperative Oncology Group phase II study

Authors

  • George Pentheroudakis Ioannina University Hospital, Ioannina, Greece
  • Evangelos Briasoulis Ioannina University Hospital, Ioannina, Greece
  • Haralambos P. Kalofonos University Hospital of Patras, Patras, Greece
  • Georgios Fountzilas Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
  • Theofanis Economopoulos University General Hospital Attikon, Athens, Greece
  • George Samelis Hippokration General Hospital, Athens, Greece
  • Aris Koutras University Hospital of Patras, Patras, Greece
  • Maria Karina Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
  • Nikolaos Xiros University General Hospital Attikon, Athens, Greece
  • Epameinondas Samantas Agii Anargiri Cancer Hospital, Athens, Greece
  • Aristotelis Bamias Alexandra Hospital, University of Athens School of Medicine, Athens
  • Nikolaos Pavlidis Ioannina University Hospital, Ioannina, Greece

DOI:

https://doi.org/10.1080/02841860701843043

Abstract

Introduction. Taxane/platinum combinations exhibit synergistic cytotoxicity and activity against a broad range of solid tumours. We sought to optimise the regimen as a suitable outpatient palliative treatment for cancer of unknown primary (CUP). Patients and methods. Eligible CUP patients with adenocarcinoma or poorly differentiated carcinoma, performance status of 0-2, adequate organ function and assessable disease were treated with docetaxel 75 mg/m2 and carboplatin at an area under the concentration time-curve (AUC) of 5, both as 30-minute intravenous infusions, every three weeks. Patients with isolated axillary adenopathy, squamous cell cervical or inguinal adenopathy and PSA or germ-cell serum tumour markers were excluded. Results. Forty-seven patients entered the trial, 24 with predominantly nodal disease or non-mucinous peritoneal carcinomatosis (favourable risk) and 23 with visceral metastases (unfavourable risk). A median of 6 cycles of chemotherapy were administered, with relative dose intensities of both drugs >90%. Response rates were 32% (46% in favourable risk, 17% in unfavourable), comparable to the activity of paclitaxel/platinum regimes, though complete remissions were seen only in favourable risk patients. Granulocyte-colony stimulating factor support was used in a third of treatment cycles. Toxicity was mild and manageable, with grade 3–4 neutropenia in 26% of patients, febrile neutropenia in 7% and severe non-hematologic side-effects in less than 8% of patients. No toxic deaths or severe neurotoxicity were seen. Median time to progression (TTP) and overall survival (OS) were 5.5 and 16.2 months respectively. Survival was driven mainly by favourable-risk patients (22.6 months), as those with visceral metastases had a poor median survival of only 5.3 months. Good performance status and low-volume disease predicted for superior outcome, while docetaxel relative dose-intensity was a positive prognosticator only in favourable-risk patients. Conclusions. One-hour docetaxel/carboplatin is a convenient, safe and effective outpatient palliative treatment for CUP patients, providing meaningful survival prolongation only in favourable-risk patients. Insights in the molecular biology of CUP are needed for the development of targeted therapeutic manipulations of malignant resistance and progression.

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Published

2008-01-01

How to Cite

Pentheroudakis, G. ., Briasoulis, E. ., Kalofonos, H. P. ., Fountzilas, G. ., Economopoulos, T. ., Samelis, G. ., … Pavlidis, N. . (2008). Docetaxel and carboplatin combination chemotherapy as outpatient palliative therapy in carcinoma of unknown primary: A multicentre Hellenic Cooperative Oncology Group phase II study. Acta Oncologica, 47(6), 1148–1155. https://doi.org/10.1080/02841860701843043