Docetaxel for Patients With Paclitaxel-Resistant Müllerian Carcinoma

Verschraegen, Claire F.; Sittisomwong, Tul; Kudelka, Andrzej P.; Guedes, Ernesto de Paula; Steger, Melissa; Nelson-Taylor, Tarra; Vincent, Monique; Rogers, Roger; Atkinson, E. Neely; Kavanagh, John J.

doi:10.1200/jco.2000.18.14.2733

Cited by 119 publications

(54 citation statements)

References 27 publications

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“…On the basis of prior reports of clinical trials with docetaxel in EOC, we had estimated that the ORR to docetaxel monotherapy would be approximately 20%. 40,[44][45][46] However, the group of patients enrolled here was heavily pretreated, and approximately 50% had received 4 prior treatments. All but 1 patient had failed on platinum within 6 months, and all 23 patients had received and failed on taxanes.…”

Section: Discussionmentioning

confidence: 99%

Imatinib mesylate in combination with docetaxel for the treatment of patients with advanced, platinum‐resistant ovarian cancer and primary peritoneal carcinomatosis

Matei

Emerson

Schilder

et al. 2008

Cancer

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BACKGROUND. Ovarian tumors frequently express c‐Kit and/or platelet‐derived growth factor receptors (PDGFRs). Imatinib mesylate blocks the growth of ovarian cancer cells in vitro and may enhance the activity of chemotherapy. This study was conducted to determine the activity of imatinib in combination with docetaxel in patients with recurrent, platinum‐resistant epithelial ovarian cancer (EOC). METHODS. Eligible patients had recurrent, platinum‐resistant, or refractory EOC that expressed PDGFRα or c‐kit, as determined by immunohistochemistry. Imatinib mesylate at a dose of 600 mg orally once daily was administered continuously with docetaxel at a dose of 30 mg/m2 given intravenously once weekly in Weeks 1 through 4 of every 6‐week cycle. The primary endpoint was objective response rate (ORR) as assessed by the Response Evaluation Criteria in Solid Tumors (RECIST). RESULTS. Thirty‐four patients were screened for PDGFRα and c‐kit expression to enroll 23 patients between December 2003 and October 2005. Four patients had c‐kit‐positive/PDGFR‐negative tumors, 11 patients had PDGFR‐positive/c‐kit‐negative tumors, and 8 patients had c‐kit‐positive/PDGFR‐positive tumors. The median patient age was 56 years (range, 33‐76 years). Patients had received a median of 3 prior treatments. The ORR was 21.7% and included 1 complete and 4 partial responses. An additional 3 patients had stable disease for more than 4months. Expression of PDGFR, c‐kit, phosphatase and tensin homolog (PTEN), and phosphorylated protein kinase B (Akt) did not predict response to therapy. The most common adverse events encountered were fatigue (83%), nausea (74%), diarrhea (61%), anorexia (52%), and edema (65%), and the majority of those events were graded as grade 1 or 2. CONCLUSIONS. The combination imatinib and docetaxel was tolerated in patients with heavily pretreated EOC that expressed c‐kit or PDGFRα. Few patients had sustained responses or stable disease. Cancer 2008. © 2008 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Imatinib mesylate in combination with docetaxel for the treatment of patients with advanced, platinum‐resistant ovarian cancer and primary peritoneal carcinomatosis

Matei

Emerson

Schilder

et al. 2008

Cancer

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“…The incomplete cross-resistance between the taxanes found preclinically, specifically the activity of docetaxel in paclitaxel-resistant disease, has been confirmed in several tumor types, specifically, breast, ovarian, and lung cancers ( Table 2) [6][7][8]. Valero and colleagues [6] evaluated the efficacy and safety of docetaxel in breast cancer patients who had previously received at least two chemotherapy regimens for metastatic disease and were progressing during paclitaxel therapy.…”

Section: Molecular Pharmacologymentioning

confidence: 99%

“…Interestingly, there were no responses observed in 12 patients who had received paclitaxel by a continuous 24-hour infusion; however, the response rate in 32 patients who received paclitaxel by either a 1-hour or 3-hour 4 Pharmacology of the Taxanes infusion was 25%. A second phase II trial evaluated two dose levels of docetaxel in patients with paclitaxel-resistant Müllerian carcinoma [7]. Resistance to paclitaxel was defined as disease progression during treatment, failure to achieve tumor regression after a minimum of four courses of therapy, or recurrence of disease within 6 months of completion of paclitaxel therapy.…”

Section: Molecular Pharmacologymentioning

confidence: 99%

Preclinical Pharmacology of the Taxanes: Implications of the Differences

2004

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Taxanes are one of the most powerful classes of compounds among all chemotherapeutic drugs. Only 30 years separate the isolation of the first taxane from the results of direct clinical comparisons in metastatic breast, ovarian, and lung cancer between the two taxanes available in routine clinical practice. These results suggest a more favorable benefit-to-risk ratio for docetaxel compared to paclitaxel when these drugs are used as single agents or in combination with other chemotherapeutic agents in an every-3-week dosing regimen. Pharmacological data support the difference between the taxanes, likely explaining the clinical results. Considering the molecular pharmacology of the two drugs, docetaxel appears to bind to β β-tubulin with greater affinity and has a wider cell cycle activity than paclitaxel. Docetaxel also appears to have direct antitumoral activity via an apoptotic effect mediated by bcl-2 phosphorylation. In addition, docetaxel has a longer retention time in tumor cells than paclitaxel because of greater uptake and slower efflux. Pharmacokinetics and pharmacodynamics of the taxanes show both agents to be extensively metabolized in the liver, and paclitaxel has a nonlinear pharmacokinetic behavior while docetaxel has linear pharmacokinetics. These differences explain the more simple treatment schedule and favorable results for docetaxel as a single agent and in combination therapy. Last, but not least, there is a pharmacokinetic interaction between paclitaxel and the anthracyclines, an active class of compounds commonly used in the treatment of breast cancer. This pharmacokinetic interaction is associated with greater cardio-and myelotoxicities, which are sequence dependent. These pharmacological data likely explain the different clinical development strategies for the two molecules as well as the different clinical results from individual trials and direct comparisons. The Oncologist 2004;9(suppl 2):3-8 The Oncologist 2004;9(suppl 2):3-8 www.TheOncologist.com

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“…Another taxane, docetaxel, at a dose of 75-100 mg/m 2 , was administered in 30 assessable for response patients with EOC, PFTC, and peritoneal carcinomatosis who failed paclitaxel-based chemotherapy [103]. The overall response rate was 23% (one complete response and six partial responses), with a median survival time of 44 weeks (9.5 months).…”

Section: Combination Chemotherapy For Advanced Diseasementioning

confidence: 99%

Fallopian Tube Carcinoma: A Review

2006

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Purpose. Primary fallopian tube carcinoma (PFTC) is a rare tumor that histologically and clinically resembles epithelial ovarian cancer (EOC). The purpose of this study is to review the current available literature data on PFTC.Patients and Results. Early clinical manifestation and prompt investigation often lead to diagnosis at an early stage of disease. However, the diagnosis of PFTC is rarely considered preoperatively and is usually first appreciated by the pathologist. Surgical staging/management and the use of chemotherapy follow the concepts used in epithelial ovarian cancer (EOC). In contrast to EOC is the importance of early lymphatic spread in this disease. The earlier diagnosis of PFTC leads to an apparent better survival compared with EOC. However, as with EOC, stage and residual tumor are the most important prognostic variables.Conclusion. Until more extensive clinical research has been performed, ovarian carcinoma management principles should be used in clinical practice. The Oncologist 2006;11:902-912

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Docetaxel for Patients With Paclitaxel-Resistant Müllerian Carcinoma

Abstract: Docetaxel is an active chemotherapeutic agent in patients with müllerian carcinoma previously treated with paclitaxel-based chemotherapy, especially in the patients who had a long taxane-free interval after a previous short response to paclitaxel.

Cited by 119 publications

References 27 publications

Imatinib mesylate in combination with docetaxel for the treatment of patients with advanced, platinum‐resistant ovarian cancer and primary peritoneal carcinomatosis

Imatinib mesylate in combination with docetaxel for the treatment of patients with advanced, platinum‐resistant ovarian cancer and primary peritoneal carcinomatosis

Preclinical Pharmacology of the Taxanes: Implications of the Differences

Fallopian Tube Carcinoma: A Review

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