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Paclitaxel, carboplatin, and gemcitabine in metastatic nasopharyngeal carcinoma
Author(s) -
Leong SwanSwan,
Wee Joseph,
Tay Miah Hiang,
Toh Chee Keong,
Tan Say Beng,
Thng Choon Hua,
Foo Kian Fong,
Lim Wan Teck,
Tan Terence,
Tan Eng Huat
Publication year - 2005
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.20804
Subject(s) - gemcitabine , medicine , carboplatin , neutropenia , nasopharyngeal carcinoma , oncology , paclitaxel , anemia , chemotherapy , gastroenterology , radiation therapy , surgery , cisplatin
BACKGROUND Patients with nasopharyngeal carcinoma (NPC) are treated primarily with radiotherapy. In the disseminated state, platinum‐based, 2‐drug combination regimens yielded response rates of 55–75%, achieving a median survival of 10–12 months. With the proven efficacy of second‐generation cytotoxics like paclitaxel and gemcitabine in patients with metastatic NPC, the authors hypothesized that a triplet combination incorporating these newer cytotoxics may improve treatment results. METHODS Thirty‐two patients with metastatic NPC were treated with combination chemotherapy that included paclitaxel 70 mg/m 2 on Days 1 and 8, carboplatin dosed to area under curve of 5 on Day 1, and gemcitabine 1000 mg/m 2 on Days 1 and 8 every 21 days for a maximum of 8 cycles. RESULTS Two patients achieved a complete response, and 23 patients achieved a partial response, for an overall response rate of 78%. The main toxicities were hematologic, with 41% of patients experiencing Grade 3 or 4 anemia, 41% of patients experiencing Grade 3 or 4 thrombocytopenia, and 78% of patients experiencing Grade 3 or 4 neutropenia. The median time to disease progression was 8.1 months, and the median overall survival was 18.6 months. CONCLUSIONS The combination of paclitaxel, carboplatin, and gemcitabine showed promising efficacy against metastatic NPC but at the expense of considerable toxicity. Cancer 2005. © 2004 American Cancer Society.