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Int J Clin Oncol (2007) 12:3136 The Japan Society of Clinical Oncology 2007 DOI 10.1007/s10147-006-0619-9
ORIGINAL ARTICLE
Angeles Alvarez Secord Laura J. Havrilesky Michael E. Carney John T. SoperDaniel L. Clarke-Pearson Gustavo C. Rodriguez Andrew Berchuck
Weekly low-dose paclitaxel and carboplatin in the treatment of advanced or recurrent cervical and endometrial cancer
Received: May 4, 2006 / Accepted: August 24, 2006
Key words Endometrial cancer Cervical cancer Chemotherapy
AbstractBackground. The purpose of this study was to evaluate the toxicity prole of weekly low-dose paclitaxel and carboplatin in patients with gynecologic malignancies.
Methods. Patients had measurable disease dened by clinical examination or radiographic studies. Each cycle of treatment consisted of carboplatin at an AUC of 2 and paclitaxel at 80 mg/m2 on days 1, 8, and 15 of a 28-day cycle.
Results. Twenty-eight patients with advanced or recurrent cervical and endometrial cancers were included in this study. The overall response rate (ORR) was 39% (2 CR, 9 PR). Among the 15 cervical cancers the ORR was 20%, while the 13 endometrial cancers had a 62% ORR. Median time to progression and overall survival was 3.4 and 7.6 months for those with cervical cancer and 5.5 and 15.4 months for those with endometrial cancer. Grade 3 or 4 hematologic toxicity was uncommon (7% grade 3 anemia, 21% grade 3 or 4 neutropenia, 7% grade 3 or 4 thrombocytopenia).
Conclusion. A regimen of weekly low-dose paclitaxel and carboplatin has an acceptable toxicity prole that is easily managed by dose adjustment and the use of erythropoietic therapy. This regimen appears to have activity in advanced or recurrent endometrial cancer which warrants further evaluation.
IntroductionCurrently there are several therapeutic options for advanced and recurrent cervical and endometrial cancers; unfortunately, in most cases they are not curative. In 2004, an estimated 4000 women with cervical cancer and 7000 with endometrial cancer died of their disease in the United States.1
Therefore, more effective treatment modalities are needed.
Advanced, persistent, or recurrent cervical cancer that is not amendable to surgical resection or radiation therapy carries a dismal prognosis. Historically, cisplatin has been considered the most active drug against cervical cancer, with initial response rates (RR) ranging from 20% to 30%.2,3
However, since the incorporation of concurrent cisplatin with radiotherapy in the primary treatment...