Carboplatin, doxorubicin and etoposide in the treatment of tumours of unknown primary site

Abstract

The aim of this study was to assess the activity and toxicity of a platinum-based treatment on a group of patients with unknown primary tumours (UPTs). Patients with a diagnosis of UPT underwent a standard diagnostic procedure. Treatment was started within 2 weeks from diagnosis and consisted of carboplatin 400 mg m À2 day 1, doxorubicin 50 mg m À2 day 1, etoposide 100 mg m À2 days 1 -3, every 21 days. Response was evaluated after three courses and treatment continued in case of objective response (OR) or symptom control. A total of 102 patients were eligible. The median age was 59 years, sex male/female 54/48, histology was mainly adenocarcinoma or poorly differentiated carcinoma. Nodes, bone, liver and lung were the most frequently involved sites. In all, 79 patients received at least three courses of treatment; 26 patients received six courses or more. Six complete responses and 21 partial responses were observed, for a total of 27 of 102 ORs or 26.5% (95% confidence interval 18.2 -36.1%). The median survival was 9 months and median progression-free survival was 4 months. Toxicity was moderate to severe, with 57.8% of patients experiencing grade III -IV haematological toxicity, mainly leucopenia. The regimen employed has shown activity in tumours of unknown primary site, but was associated with significant toxicity. Such toxicity may be considered unjustified, given the large proportion of patients with tumours not likely to respond. Efforts should therefore be addressed to identify predictors of response to chemotherapy, thus limiting aggressive treatment to those patients who could benefit from it.

Cisplatin and gemcitabine with either vinorelbine or paclitaxel in the treatment of carcinomas of unknown primary site

“…In 2004, Piga et al 31 confirmed response and survival data when using a platinum-containing regimen (carboplatin, doxorubicin, and etoposide) in a Phase II study of 102 patients with CUP. An ORR of 26.5% and an OS of 9 months (progression-free survival, 4 months) were reported, whereas the main toxicity was grade 3 or 4 hematologic toxicity, which was reported in 57.8% of patients.…”

Identification of Clinical Prognostic Factors in Patients with Unknown Primary Tumors Treated with a Platinum-Based Combination

“…The clinical database from which the study variables were derived included baseline and follow-up information on 102 UPT patients enrolled in a phase II trial of platinum-based therapy [17]. The study was started in January 1991 as a three-institution study (Ancona, Verona, Pesaro), and opened by the end of the year to other collaborating centers (see Acknowledgments).…”

“…Survival was calculated from entry into the study till last observation or death. Other details of the study are reported elsewhere [17]. …”

“…The results of this study in terms of response to treatment and toxicity are reported elsewhere [17]. In this report we evaluated the potential impact of several clinical variables on tumor response to treatment and patient survival, with a follow-up in excess of 7 years.…”

Palliative Chemotherapie bei CUP: Ärztliche Intentionen versus Patientenhaltung in der Entscheidungsfindung – ein Fallbeispiel

“…Hinsichtlich Chemotherapie bei "cancer of unknown primary" existiert eine Unzahl von rezenten Arbeiten meist Phase II Studien welche sich meist nur schwer miteinander vergleichen lassen [2,5,7,10,11,15]. Übersichtsar-beiten [8] bzw.…”