The Use of Paclitaxel and Platinum-Based Chemotherapy in Uterine Papillary Serous Carcinoma

• Published in: Gynecologic oncology Vol. 74; no. 2; pp. 272 - 277
• Main Authors: Zanotti, Kristine M., Belinson, Jerome L., Kennedy, Alexander W., Webster, Kenneth D., Markman, Maurie
• Format: Journal Article Conference Proceeding
• Language: English
• Published: San Diego, CA Elsevier Inc 01.08.1999; Elsevier
• Subjects: Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; CA-125 Antigen - blood; Carboplatin - administration & dosage; Cisplatin - administration & dosage; Cystadenocarcinoma, Papillary - blood; Cystadenocarcinoma, Papillary - drug therapy; Cystadenocarcinoma, Papillary - mortality; Cystadenocarcinoma, Papillary - pathology; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - epidemiology; paclitaxel; Paclitaxel - administration & dosage; Retrospective Studies; Survival Rate; Tumors; Uterine Neoplasms - blood; Uterine Neoplasms - drug therapy; Uterine Neoplasms - mortality; Uterine Neoplasms - pathology; uterine papillary serous carcinoma; paclitaxel; uterine papillary serous carcinoma; Antineoplastic agent; Human; Drug combination; Malignant tumor; Female genital diseases; Chemotherapy; Treatment; Platinum; Taxane derivatives; Paclitaxel; Uterine diseases; Female; Antimitotic; Endometrium
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1006/gyno.1999.5444

Objective. Uterine papillary serous carcinoma (UPSC) is an aggressive malignancy with a histologic appearance and pattern of spread that resembles that of papillary serous adenocarcinoma of the ovary. The current standard therapy for advanced ovarian cancer, cisplatin or carboplatin plus paclitaxel, results in high objective response rates for that tumor. This regimen has thus far not been evaluated in UPSC. Methods. Twenty-four patients with UPSC treated with platinum-based chemotherapy and paclitaxel were retrospectively evaluated. Eighteen patients received these agents in the adjuvant setting (n = 9) or for disease persistent after initial surgical management (n = 9). Eleven patients received one or more courses of this drug combination for recurrent disease, 5 of whom had prior exposure in the initial setting. Results. Mean follow-up was 35 months (range 6–72+). A median progression-free interval (PFI) of 30 months (range 8–61+) was seen in patients treated in the adjuvant setting. Objective response, indicated by normalization of an elevated prechemotherapy CA125 level, was seen in 8 of 9 patients treated for residual disease after initial surgery (median PFI of 13 months, range 5–38+). Objective response of both measurable and/or evaluable disease was seen in 7 of 11 patients treated for recurrent disease (median PFI of 9 months, range 4–18). Six patients had retreatment with one or both agents and 4 responded a second time. Overall, the regimen was well tolerated. Conclusion. Paclitaxel and platinum-based chemotherapy has demonstrated activity in UPSC with acceptable toxicity. These results merit further investigation of the possible role of these agents in patients with this aggressive histologic subtype.