CISPLATIN AND 5-FLUOROURACIL FOR METASTATIC SQUAMOUS-CELL CARCINOMA FROM UNKNOWN PRIMARY

Chemotherapy for squamous cell carcinoma with unknown primary (SCUP) has not been prospectively studied. To evaluate the efficacy of cis-diaminedichloroplatinum (cisplatin) and 5-fluorouracil (5-FU) in advanced SCUP, we treated 15 patients with measurable disease. A prospective trial was conducted of cisplatin and 5-FU in patients presenting with SCUP. All patients had evaluation in search for primary disease with computed tomographic scan of the head, neck, and chest-and endoscopic evaluation of the nasopharynx, larynx, esophagus, and tracheobronchial passages with negative blind biopsies. Chemotherapy consisted of cisplatin 100 mg/m(2) on day 1 and 5-FU 1000 mg/m(2) continuous infusion over 24 hr for 4 days. The regimen was repeated every 21 days. Responses were seen in 8 of 15 patients [1 complete response (CR) and 7 partial responses (PR)], for an overall response rate of 53%. These results suggest that cisplatin-5-FU combination has efficacy in advanced SCUP and deserves further trials both in advanced disease and in combined modality programs with surgery and radiation therapy.