Objective The objective of the study was to evaluate the response of weekly paclitaxel/carboplatin in patients with primary advanced or recurrent endometrial cancer.
Methods Eighteen cycles of paclitaxel (60 mg/m2) and carboplatinum (area under the plasma concentration-time curve, 2.7) were administered weekly. Response rates were evaluated according to Response Criteria in Solid Tumors criteria.
Results Paclitaxel/carboplatin weekly was administered to 29 patients. Median age was 62 years (range, 44–80 years). Main histopathologic types were serous/clear cell (n = 16) and endometrioid (n = 9). Patients were divided into a chemonaive group (n = 16) (group 1) and a group with previous chemotherapy (n = 13) (group 2). Response rate for group 1 was as follows: partial remission, n = 8 (50%); stable disease, n = 1 (6%); and progressive disease, n = 7 (44%). Response for group 2: partial remission, n = 5 (39%), and progressive disease, n = 8 (62%). Median progression-free survival and overall survival were 9 months (range, 5–27 months) and 12 months (range, 2–27 months), respectively, for group 1 and 8 months (range, 6–10 months) and 9 months (range, 2–18 months), respectively, for group 2.
Overall 411 weekly treatments were administered. Because of grade 4 bone marrow toxicity, treatments needed to be adjusted as follows: dose reduction of 50% to 75%, n = 81 (20%); dose delay, n = 66 (16%); not administered, n = 6 (1%); and changed to paclitaxel/cisplatin, n = 4 (1%). Twenty-three patients (85%) needed treatment adjustment because of toxicity. Neutropenic fever occurred in 1 patient (4%). The most common nonhematologic toxicities were grade 1 to 2 fatigue (89%) and grade 2 nausea (37%). Seven percent had grade 2 neuropathy. No grade 2 alopecia occurred.
Conclusions Paclitaxel/carboplatin weekly seems effective, however, with a considerable hematologic toxicity. Larger trials are needed to confirm these data.
- Advanced disease
- Endometrial cancer
- Weekly regimen
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Dr Amant is clinical researcher for the Research Foundation, Flanders (F.W.O.).