Paclitaxel and carboplatin vs gemcitabine and vinorelbine in patients with adeno- or undifferentiated carcinoma of unknown primary: a randomised prospective phase II trial

被引:53
作者
Huebner, G. [1 ]
Link, H. [1 ]
Kohne, C. H. [2 ]
Stahl, M. [3 ]
Kretzschmar, A. [4 ]
Steinbach, S. [1 ]
Folprecht, G. [2 ]
Bernhard, H. [5 ]
Al-Batran, S. E. [6 ]
Schoffski, P. [7 ]
Burkart, C. [8 ]
Kullmann, F. [9 ]
Otremba, B.
Menges, M. [10 ]
Hoffmann, M. [11 ]
Kaiser, U. [12 ]
Aldaoud, A.
Jahn, A. [13 ]
机构
[1] Westpfalz Klinikum, D-67655 Kaiserslautern, Germany
[2] Univ Hosp Carl Gustav Carus, D-01307 Dresden, Germany
[3] Kliniken Essen Mitte, D-45136 Essen, Germany
[4] Helios Klinikum Berlin Buch, D-13125 Berlin, Germany
[5] Univ Hosp Rechts Isar, D-81675 Munich, Germany
[6] Klinikum Frankfurt Nordwest, D-60488 Frankfurt, Germany
[7] Hannover Med Sch, D-30623 Hannover, Germany
[8] Eberhard Karls Univ Hosp, D-72076 Tubingen, Germany
[9] Univ Hosp, D-93042 Regensburg, Germany
[10] Saarland Univ Hosp, D-66421 Homburg, Germany
[11] Klinikum Stadt Ludwigshafen, D-67063 Ludwigshafen, Germany
[12] St Bernward Hosp, D-31334 Hildesheim, Germany
[13] Johannes Gutenberg Univ Mainz, D-55131 Mainz, Germany
关键词
neoplasms; unknown primary; randomized controlled trial; clinical trial; phase II; medical oncology; anti-neoplastic-combined chemotherapy protocols; CANCER-RESEARCH-NETWORK; CELL LUNG-CANCER; PRIMARY SITE; PRIMARY TUMORS; CHEMOTHERAPY; EPIDEMIOLOGY; COMBINATION; CISPLATIN; ETOPOSIDE; DOCETAXEL;
D O I
10.1038/sj.bjc.6604818
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Platinum/taxane combinations are widely used in patients with carcinoma of unknown primary (CUP), yielding response rates of 30% and median overall survival of 9-11 months in selected patients. Yet these combinations have not been subject to a randomised trial to overcome selection bias, a major problem in CUP. We randomised 92 patients to either paclitaxel/carboplatin (arm A) or the non-platinum non-taxane regimen gemcitabine/vinorelbine (arm B). The primary endpoint was rate of practicability as defined: application of >= 2 cycles of therapy ( 1) with a maximal delay of 1 week ( 2) and survival of >= 8 months ( 3). Practicability was shown in 52.4% (95% CI 36-68%) in arm A and in 42.2% ( 95% CI 28-58%) in arm B, respectively. The median overall survival, 1-year survival-rate and response rate of patients treated in arm A was 11.0 months, 38, and 23.8%, arm B 7.0 months, 29, and 20%. In conclusion, the paclitaxel/carboplatin regimen showed clinically meaningful activity in this randomised trial (Clinical trial registration number 219, 'Deutsches KrebsStudienRegister', German Cancer Society.)
引用
收藏
页码:44 / 49
页数:6
相关论文
共 22 条
[1]   Combination regimen with carboplatin, epirubicin and etoposide in metastatic carcinomas of unknown primary site: A Hellenic Co-Operative Oncology Group phase II study [J].
Briasoulis, E ;
Tsavaris, N ;
Fountzilas, G ;
Athanasiadis, A ;
Kosmidis, P ;
Bafaloukos, D ;
Samantas, E ;
Pavlidis, N .
ONCOLOGY, 1998, 55 (05) :426-430
[2]   Gene expression profiling may improve diagnosis in patients with carcinoma of unknown primary [J].
Bridgewater, J. ;
van Laar, R. ;
Floore, A. ;
Van't Veer, L. .
BRITISH JOURNAL OF CANCER, 2008, 98 (08) :1425-1430
[3]   Cisplatin in combination with either gemcitabine or irinotecan in carcinomas of unknown primary site:: Results of a randomized phase II study-trial for the French Study Group on Carcinomas of Unknown Primary (GEFCAPI 01) [J].
Culine, S ;
Lortholary, A ;
Voigt, JJ ;
Bugat, R ;
Théodore, C ;
Priou, F ;
Kaminsky, MC ;
Lesimple, T ;
Pivot, X ;
Coudert, B ;
Douillar, JY ;
Merrouche, Y ;
Allouache, J ;
Goupil, A ;
Négrier, S ;
Viala, J ;
Petrow, P ;
Bouzy, J ;
Laplanche, A ;
Fizazi, K .
JOURNAL OF CLINICAL ONCOLOGY, 2003, 21 (18) :3479-3482
[4]   A phase II study of carboplatin and paclitaxel in adenocarcinoma of unknown primary [J].
El-Rayes, BF ;
Shields, AF ;
Zalupski, M ;
Heilbrun, LK ;
Jain, V ;
Terry, D ;
Ferris, AM ;
Philip, PA .
AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS, 2005, 28 (02) :152-156
[5]  
Fizazi K., 2006, CARCINOMA UNKNOWN PR, P105
[6]   Gemcitabine, carboplatin, and paclitaxel for patients with carcinoma of unknown primary site: A Minnie Pearl Cancer Research Network study [J].
Greco, FA ;
Burris, HA ;
Litchy, S ;
Barton, JH ;
Bradof, JE ;
Richards, P ;
Scullin, DC ;
Erland, JB ;
Morrissey, LH ;
Hainsworth, JD .
JOURNAL OF CLINICAL ONCOLOGY, 2002, 20 (06) :1651-1656
[7]   Carcinoma of unknown primary site: Treatment with 1-hour paclitaxel, carboplatin, and extended-schedule etoposide [J].
Hainsworth, JD ;
Erland, JB ;
Kalman, LA ;
Schreeder, MT ;
Greco, FA .
JOURNAL OF CLINICAL ONCOLOGY, 1997, 15 (06) :2385-2393
[8]   Phase II trial of bevacizumab and erlotinib in carcinomas of unknown primary site: The Minnie Pearl Cancer Research Network [J].
Hainsworth, John D. ;
Spigel, David R. ;
Farley, Cindy ;
Thompson, Dana S. ;
Shipley, Dianna L. ;
Greco, F. Anthony .
JOURNAL OF CLINICAL ONCOLOGY, 2007, 25 (13) :1747-1752
[9]  
HUEBNER G, 2007, EJC SUPPL, V5, pA503
[10]   Molecular profiling of a tumor of unknown origin [J].
Ismael, Gustavo ;
de Azambuja, Evandro ;
Awada, Ahmad .
NEW ENGLAND JOURNAL OF MEDICINE, 2006, 355 (10) :1071-1072