Efficacy and Safety Assessment of Paclitaxel in Patients with Docetaxel-Resistant Esophageal Squamous Cell Carcinoma

Abstract

Background: Incomplete cross-resistances between paclitaxel (PTX) and docetaxel (DTX) has been demonstrated in several types of cancer. The objective of the present study was to assess the existence of cross-resistance between PTX and DTX in esophageal squamous cell carcinoma. Methods: Patients in the PTX group received PTX without DTX pretreatment, patients in the prior DTX (Pr-DTX) group received PTX after the development of resistance to DTX, and patients in the DTX group received DTX without subsequent PTX treatment. Results: A total of 73 patients were enrolled. The response rates to PTX in the PTX and Pr-DTX groups were 22.7 and 20.0%, respectively. The median progression-free survival times from the first day of PTX treatment in the PTX and Pr-DTX groups were 113 (95% CI 56-154) and 97 days (95% CI 36-189), respectively. The median overall survival times from the first day of DTX treatment in the Pr-DTX and DTX groups were 315 (95% CI 124-453) and 148 days (95% CI 139-177), respectively. Conclusions: There is no or incomplete clinical cross-resistance between PTX and DTX in esophageal squamous cell carcinoma. Replacement of DTX with PTX is a suitable treatment option for patients with DTX-resistant esophageal squamous cell carcinoma.

Taxane rechallenge during metastatic disease in HER-2 negative breast cancer patients: Clinical activity, tolerance and survival results

“…These results are consistent with the reported moderate efficacy of a second, different taxane treatment in some patients presenting with various cancer types and who became refractory to a first taxane treatment, when paclitaxel and docetaxel were used sequentially in the same patients [ [13] , [14] , [15] , [16] ].…”

Phase III randomized, double‐blind study of paclitaxel with and without everolimus in patients with advanced gastric or esophagogastric junction carcinoma who have progressed after therapy with a fluoropyrimidine/platinum‐containing regimen (RADPAC)

“…The rationale for enrollment of patients with prior docetaxel therapy in our study is supported by data showing that weekly paclitaxel is active in gastric cancer patients who had been refractory to docetaxel containing chemotherapy 22 . This indicates that cross‐resistance between docetaxel and paclitaxel in gastric cancer is incomplete 23‐25 . However, studies assessing the efficacy of taxane re‐exposure show inconsistent results, mainly because numbers of patients are small and in various treatment lines and analyses are mostly retrospective.…”

“…13 OS in both arms was comparable to the paclitaxel mono arm in western patients in the RAINBOW trial (5.9 months 200/398 patients), 7 underlying the poor 22 This indicates that cross-resistance between docetaxel and paclitaxel in gastric cancer is incomplete. [23][24][25] However, studies assessing the efficacy of taxane re-exposure show inconsistent results, mainly because numbers of patients are small and in various treatment lines and analyses are mostly retrospective. Our results regarding efficacy of taxane-rechallenge seem to be even worse than previous reports with a median survival of only 3.9 months in the paclitaxel control arm, which is close to those of patients who receive best supportive care only in second-and third-line setting (3.6-4.3 months).…”

A Pilot Trial of S-1 and Paclitaxel in Unresectable or Postoperative Recurrent Esophageal Squamous Cell Carcinoma Pretreated by Fluorouracil, Cisplatin, and Docetaxel Chemotherapy

“…Regarding ESCC, PTX monotherapy shows feasible efficacy, with an overall response rate of 44.2%, median duration of response of 4.8 months, and median OS of 10.4 months with manageable toxicity as a second-line regimen for patients previously treated with platinumbased chemotherapy [5]. Furthermore, it has also been reported that there is either no clinical cross-resistance or incomplete clinical cross-resistance between PTX and DOC in ESCC [23].…”