Leuven dose-dense paclitaxel/carboplatin regimen in patients with primary advanced or recurrent endometrial carcinoma

Int J Gynecol Cancer. 2009 Aug;19(6):1147-51. doi: 10.1111/IGC.0b013e3181ad3dcb.

Abstract

Objective: To evaluate the response of dose-dense paclitaxel/carboplatin (TC) patients with primarily advanced or recurrent endometrial cancer.

Methods: Six courses of paclitaxel (90 mg/m2) and carboplatinum (area under the curve, 4) on days 1 and 8 every 3 weeks were administered. Response rates were evaluated according to the response evaluation criteria in solid tumors.

Results: Dose-dense TC was administered to 42 patients. The median age was 63.9 years (range, 41-81 years). The main histopathologic types were serous/clear cell (n = 27) and endometrioid (n = 13). The patients were divided in 2 groups: chemotherapy-naive group (n = 28, group 1) and a group with previous chemotherapy (n = 14, group 2).The responses for group 1 were as follows: 11 (39 %) complete response, 9 (32%) partial response, and 2 (7%) stable disease. The responses for group 2 were 1 (7%) complete response, 2 (14%) partial response, and 6 (43%) stable disease. Treatment-related death occurred in 1 patient (7%) because of neutropenia and nephrotoxicity.Progression-free survival for group 1 was 10 months (range, 4-19 months). At time of analysis, 57% of the patients were still alive after a median follow-up of 10 months (range, 4-21 months). Progression-free survival for group 2 was 11 months (range, 4-19 months).Because of grades 3 and 4 hematologic toxicity, treatment adjustments were as follows: 49 (18%) and 18 (19%) dose reductions (carboplatin area under the curve, 2-3), 35 (13%) and 14 (15%) dose delays, and 8 (3%) and 6 (6%) treatments were not administered on day 8 for groups 1 and 2, respectively.

Conclusions: Administration of dose-dense TC resulted in a response rate of 71% in chemotherapy-naive patients. Treatment modifications due to toxicity were frequent, but severe complications such as neutropenic fever occurred in a similar incidence as other reported 3-weekly regimens.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carboplatin / administration & dosage*
  • Carboplatin / adverse effects
  • Carcinoma / drug therapy*
  • Carcinoma / mortality
  • Carcinoma / pathology
  • Disease Progression
  • Dosage Forms
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Endometrial Neoplasms / drug therapy*
  • Endometrial Neoplasms / mortality
  • Endometrial Neoplasms / pathology
  • Female
  • Humans
  • Middle Aged
  • Paclitaxel / administration & dosage*
  • Paclitaxel / adverse effects
  • Recurrence
  • Remission Induction / methods
  • Survival Analysis

Substances

  • Dosage Forms
  • Carboplatin
  • Paclitaxel