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

Huebner, G.; Link, Hartmut; Köhne, Claus‐Henning; Stahl, Michael; Kretzschmar, Albrecht; Steinbach, Silke; Folprecht, Gunnar; Bernhard, Helga; Al‐Batran, Salah‐Eddin; Schöffski, Patrick; Burkart, Christoph; Kullmann, Frank; Otremba, Burkhard; Menges, med.dent. Joachim; Hoffmann, Martin; Kaiser, Ulrich; Aldaoud, Ali; Jahn, Andreas

doi:10.1038/sj.bjc.6604818

Cited by 74 publications

(59 citation statements)

References 22 publications

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“…40) and median OS of 6.5 months (95% CI 5.5-10.1) [65]. However, in comparison to nonplatinum based doublets such as gemcitabine-vinorelbine, carboplatin-paclitaxel remains superior in terms of both median OS (7.0 months vs 11.0 months) and 1-year survival rate (38% vs 29%) [66]. A comparative phase II study of carboplatin-docetaxel and cisplatindocetaxel revealed that both regimens had similar response (22% vs 26%) and median OS rates (8 months for each arm).…”

Section: Cancer Of Unknown Primary (Cup)mentioning

confidence: 99%

“…The treatment of poorly differentiated CUP centres on carboplatin-based regimens including carboplatin-gemcitabine, carboplatin-paclitaxel and carboplatin-docetaxel [64][65][66]. The carboplatin-paclitaxel doublet appears to be effective in patients with predominantly nodal and pleural based metastasis of unknown origin with 68.4% ORR and median OS of 15 months [64].…”

Section: Cancer Of Unknown Primary (Cup)mentioning

confidence: 99%

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Cisplatin versus carboplatin: comparative review of therapeutic management in solid malignancies

Woodward

Coward

2016

Critical Reviews in Oncology/Hematology

248

135

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2 Highlights Platinum analogues, cisplatin and carboplatin, represent some of the most active cytotoxic agents in clinical oncology and are the backbone of most chemotherapeutic regimens  Despite relative similarities in mechanisms of action and activities, there are significant differences in both efficacy and toxicities for both platinum analogues in various malignancies  Carboplatin is a useful alternative in situations where cisplatin is contraindicated and this is not universally at the expense of efficacy  Platinum resistance, both de novo and acquired, is inevitable and understanding the mechanisms of resistance is essential in improving outcomes  Despite the burgeoning era of targeted therapies, the role of efficient DNA damaging agents such as platinum salts remains paramount especially in combination with these novel drugs.3 AbstractThe platinum analogues, cisplatin and carboplatin, are among the most widely used chemotherapeutic agents in oncology. Both agents have a broad spectrum of clinical activity in numerous malignancies including gynaecological cancers, germ cell tumours, head and neck cancer, thoracic cancers and bladder cancer. Although the final mechanism of inducing tumour cell apoptosis is similar for both compounds, cisplatin has been shown to be more effective in treating specific tumour types. Whilst more favourable toxicity profiles are often associated with carboplatin, this can frequently translate to inferior response in certain malignancies. This review succinctly collates the evidence for the preferential use of these platinum analogues in particular settings in addition to the long-standing dilemma surrounding the paucity of biomarkers predicting response to these agents.

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Section: Cancer Of Unknown Primary (Cup)mentioning

confidence: 99%

Section: Cancer Of Unknown Primary (Cup)mentioning

confidence: 99%

Cisplatin versus carboplatin: comparative review of therapeutic management in solid malignancies

Woodward

Coward

2016

Critical Reviews in Oncology/Hematology

248

135

View full text Add to dashboard Cite

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“…69 In a randomized prospective phase II study conducted by the German CUP Study Group, the paclitaxel and carboplatin combination showed better clinical activity than the gemcitabine and vinorelbine combination. 70 The median overall survival, 1-year survival rate, and response rate were 11.0 months, 38%, and 23.8%, respectively, for patients treated with paclitaxel and carboplatin, compared with 7.0 months, 29%, and 20%, respectively, for those treated with gemcitabine and vinorelbine. Sequential treatment with paclitaxel/carboplatin/etoposide and gemcitabine/irinotecan was also found to be active in patients with occult primary tumors.…”

Section: Treatment Options Chemotherapymentioning

confidence: 99%

Occult Primary

Ettinger¹,

Agulnik²,

Cates³

et al. 2011

J Natl Compr Canc Netw

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“…For example, metastases of adenocarcinoma in axillary lymph nodes in women will be treated as metastasized breast cancer, and metastases of squamous cell carcinoma in cervical lymph nodes will be treated as head and neck cancer [5,6]. For other CUPs that do not belong to a defined subcategory, standardized chemotherapeutic regimens have been proposed, too [3,7,8]. This is a pragmatic approach, since at one point, it is required to begin therapy and cease redundant search for the unknown primary, which will be diagnosed during the further course of disease in only 7% of patients [9].…”

Section: Introductionmentioning

confidence: 99%

Comparison of histopathological and gene expression-based typing of cancer of unknown primary

et al. 2009

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For the clinical diagnosis and appropriate therapy of patients with cancer of unknown primary (CUP), biopsies of the tumor metastases are generally examined histopathologically and by immunohistochemistry (IHC). Gene expression profiling (GEP) is a new diagnostic technique that might further contribute to tumor specification. Biopsies of 43 CUP cases underwent a retrospective central histopathological and immunohistochemical review and centrally performed GEP using CupPrint(TM). Two samples could not be evaluated by IHC due to small biopsy size or loss of immunoreactivity. One of these and 17 other samples were not suited for GEP due to RNA degradation. In 13 out of the remaining 24 cases (54%), the same primary was proposed by IHC and GEP and was supported by the clinical findings, furthermore leading to the doubtless identification of the primary in four out of these. In seven cases, there was discordance between IHC and GEP, with the clinical picture being more in line with IHC in three and with GEP in four cases. Four cases had to remain undecided because the primary tumors suggested by IHC and GEP were not supported. In conclusion, overlap between IHC and GEP results and the clinical presentation was noted in the majority of those true CUP cases that were evaluable with both techniques. Therefore, GEP can be a complementary diagnostic technique assisting immunohistochemical profiling of cancer biopsies with unknown primary.

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

Cited by 74 publications

References 22 publications

Cisplatin versus carboplatin: comparative review of therapeutic management in solid malignancies

Cisplatin versus carboplatin: comparative review of therapeutic management in solid malignancies

Occult Primary

Comparison of histopathological and gene expression-based typing of cancer of unknown primary

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