Phase I study of taxol and granulocyte colony-stimulating factor in patients with refractory ovarian cancer.
OBJECTIVE
To increase the taxol dose beyond the current standard dose intensity of 175 mg/m2 per 21 days in patients with refractory ovarian cancer.


METHODS
Fifteen patients who had platinum-refractory or recurrent advanced-stage ovarian cancer were treated with taxol in a phase I trial and were given granulocyte-colony stimulating factor (G-CSF). Taxol was administered at doses of 170, 200, 250, and 300 mg/m2 every 3 weeks. G-CSF was given as a daily subcutaneous injection that started 24 hours after the completion of the taxol infusion.


RESULTS
Four patients required either taxol dose reduction or delay. The dose-limiting toxicity (DLT) was peripheral neuropathy, and it occurred at 300 mg/m2. This toxicity was manifested clinically as a stocking-and-glove sensory disturbance that primarily affected proprioception, and was associated with objective changes on nerve conduction studies in affected individuals. Mucositis was rarely observed. Substantial myelosuppression was observed, but was not dose-limiting. Five of 14 assessable patients experienced an objective response to therapy, with another five individuals who experienced a 30% to 45% reduction in tumor mass.


CONCLUSIONS
Taxol can be safely administered in doses up to 250 mg/m2 with G-CSF support, which may make it possible to study taxol dose intensification.
Sarosy
G
G
Medicine Branch, National Cancer Institute, Bethesda, MD 20892.
Kohn
E
E
Stone
D A
DA
Rothenberg
M
M
Jacob
J
J
Adamo
D O
DO
Ognibene
F P
FP
Cunnion
R E
RE
Reed
E
E
D000328:Adult; D000368:Aged; D000470:Alkaloids / Q000008:administration & dosage* / Q000009:adverse effects; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage* / Q000009:adverse effects; D001855:Bone Marrow Diseases / Q000139:chemically induced / Q000517:prevention & control*; D002277:Carcinoma / Q000188:drug therapy; D004341:Drug Evaluation; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D017239:Paclitaxel; D016896:Treatment Outcome
D000470:Alkaloids; D000972:Antineoplastic Agents, Phytogenic; D016179:Granulocyte Colony-Stimulating Factor; D017239:Paclitaxel