Paclitaxel/Carboplatin/Etoposide Versus Gemcitabine/Irinotecan in the First-Line Treatment of Patients With Carcinoma of Unknown Primary Site

Abstract

The PCE and gemcitabine/irinotecan regimens have comparable efficacy in the first-line treatment of patients with carcinoma of unknown primary site. Gemcitabine/irinotecan is the preferable regimen, due to its favorable toxicity profile. However, the moderate efficacy of both regimens underscores the need for novel treatment approaches in this patient population.

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

“…Serious toxicities were low reported in present study because of retrospective nature. In previous studies, serious hematological toxicities (12-17%) and nonhematological (3-30%) were reported and there were no toxic death (Fernandez-Cotarelo et al, 2010;Hainsworth et al, 2010). There are several prognostic factors such as multiple metastatic sites, liver metastasis, elevated lactate dehydrogenase level (Culine et al, 2002;Seve et al, 2006).…”

“…Although different chemotherapy regimens were evaluated, there is no standard treatment, currently. Platin based regimens are mostly used and the results of phase II Umut Demirci 1 *, Ugur Coskun 2 , Halit Karaca 3 , Faysal Dane 4 , Nuriye Yıldırım Ozdemir 5 , Arife Ulas 6 , Meltem Baykara 7 , Mustafa Benekli 2 , Metin Ozkan 3 , Suleyman Buyukberber 2 taxane studies are promising in patients with CUP (Poussel et al, 2004;Adenis et al, 2010;Hainsworth et al, 2010). Here-in, we evaluated our multicentric retrospective experience for CUP administering docetaxel and cisplatin in combination therapy.…”

CUP Syndrome

“…Larger studies on systemic chemotherapy report a median survival of 8-11 months and a 2-year survival of 20% for disseminated CUP syndrome (21).…”

“…Internationally accepted standards of treatment for adenocarcinomas with no indication of enteral origin, and for undifferentiated carcinomas, are combination chemotherapy of a platinum substance (cisplatin, carboplatin) and a taxane, gemcitabine, or irinotecan, or (in the case of contraindication to platinum) platinum-free combination therapies or monotherapies (21). In the case of clinical presentation of adenocarcinoma compatible with a colon tumor, therapy should be analogous to that of metastatic colon carcinoma.…”

Occult Primary

“…68 In a recent phase III randomized study, the triple-drug regimen had comparable efficacy to gemcitabine and irinotecan in the first-line treatment of patients with CUP. 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.…”