Docetaxel and Cisplatin in First Line Treatment of Patients with Unknown Primary Cancer: A Multicenter Study of the Anatolian Society of Medical Oncology

Abstract

Background: The overall prognosis for cancers of unknown primary (CUP) is poor, median overall survival (OS) being 6-12 months. We evaluated our multicentric retrospective experience for CUP administered docetaxel and cisplatin combination therapy. Materials and Methods: A total of 29 patients that were pathologically confirmed subtypes of CUP were included in the study. The combination of docetaxel (75 mg/m 2 , day 1) and cisplatin (75 mg/m 2 , day 1) was performed as a first line regimen every 21 days. Results: The median age was 51 (range: 27-68). Some 17 patients had multimetastatic disease on the inital diagnosis. Histopathological diagnoses were well-moderate differentiated adenocarcinoma (51.7%), undifferentiated carcinoma (27.6%), squamous cell cancer (13.8%), mucoepidermoid carcinoma (3.4%) and neuroendocrine differentiated carcinoma (3.4%). Median number of cycles was 3 (range: 1-6). Objective response rate was 37.9% and clinical benefit was 58.6%. Median progression free survival (PFS) and overall survival (OS) were 6 months (range: 4.3-7.7 months) and 16 months (range: 8.1-30.9 months), respectively. Fourteen patients (60.8%) were treated in a second line setting. There was no treatment related death. Most common toxicities were nausia-vomiting (44.6%) and fatigue (34.7%), serious cases (grade 3/4) suffering nausia-vomiting (10.3%), neutropenia (13.8%) and febrile neutropenia (n=1). Conclusion: The combination of cisplatin and docetaxel is an effective regimen for selected patients with CUP.

Undifferentiated prostate cancer treated with docetaxel

“…The median time of overall survival ranged from 12 to 18 months, which was clearly shorter than the median survival typically observed in more common types of prostate cancer. 2,9,10 Consistent with these earlier reports, platinum-based chemotherapy, such as SOX or EP therapy, did not prevent disease progression in our case. Although chemoradiotherapy combined with hormonal therapy played a role in shrinking the tumor and controlling some symptoms caused by cancer progression, its efficacy was limited to temporary local control.…”

Neuroendocrine tumors in the Iran Cancer Institute: Predictive Factors of Patient Survival

“…However, some studies have estimated a 5-year survival which is much higher than this study (Durante et al, 2009;Demirci et al, 2014).…”

“…Sorbye and colleagues results were similar in treatment of neuroendocrine tumors (Sorbye et al, 2013). There is another study using combination of docetaxol and cisplatin in the treatment of metastatic neuroendocrine tumors of unknown origin regardless of differentiation of tumors (Demirci et al, 2014). However, only 3.4% of tumors were reported as well differentiated and toxicity was high.…”

A Simple Risk Model to Predict Survival in Patients With Carcinoma of Unknown Primary Origin

“…Platinum-based chemotherapy in combination with paclitaxel, docetaxel, gemcitabine, and irinotecan has been reported to have objective response rates ranging from 18% to 55%. 41 – 45 Although there is no standard treatment for CUP, proper management can still lead to long-term survivorship. Kaizu et al demonstrated that definitive chemoradiation with platinum-based chemotherapy for cervical lymph node metastases from CUP was well tolerated, with a 5-year overall survival of 52%.…”