title: Prospective treatment of advanced or recurrent endometrial carcinoma with cisplatin, doxorubicin, and cyclophosphamide.
abstract: Both single-agent cisplatin and the combination of doxorubicin and cyclophosphamide demonstrated moderate activity against endometrial carcinoma in earlier salvage trials. Since January 1979, 102 patients with advanced primary (n = 42) or recurrent (n = 60) endometrial carcinoma were prospectively treated with cisplatin (50 mg/m2), doxorubicin (50 mg/m2), and cyclophosphamide (500 mg/m2) (PAC). PAC was administered monthly until disease progression or toxicity precluded additional therapy. Patients received a median of five treatment cycles (range 1-13). Of the 87 patients with measurable disease, 12 had a complete clinical response, while 27 had a partial clinical response, for an overall objective response rate of 45%. No differences in response rates between primary and recurrent disease patients were noted. Median time to response was 2.5 months with a median response duration of 4.8 months. Nonresponders included 33 patients with stable disease and 15 with progression. Median progression-free survival for all patients was 6 months. Dose escalation was possible in 25% of patients; however, 52% of patients required dose reductions during treatment. Clinically significant toxicities included neutropenia (65%), anemia (47%), emesis (21%), nephrotoxicity (17%), and neurotoxicity (4%). Our study indicates that endometrial cancer is significantly responsive to PAC. Enthusiasm for this regimen should be tempered by the limited duration of response and substantial treatment toxicity.
authors.affiliation: Department of Gynecology, University of Texas, M. D. Anderson Cancer Center, Houston 77030.
authors.forename: T W
authors.initials: TW
authors.lastname: Burke
authors.forename: C A
authors.initials: CA
authors.lastname: Stringer
authors.forename: M
authors.initials: M
authors.lastname: Morris
authors.forename: R S
authors.initials: RS
authors.lastname: Freedman
authors.forename: D M
authors.initials: DM
authors.lastname: Gershenson
authors.forename: J J
authors.initials: JJ
authors.lastname: Kavanagh
authors.forename: C L
authors.initials: CL
authors.lastname: Edwards
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D011446:Prospective Studies; D014594:Uterine Neoplasms / Q000188:drug therapy* / Q000401:mortality
chemical_list: D004317:Doxorubicin; D003520:Cyclophosphamide; D002945:Cisplatin