Taxol: a unique antineoplastic agent with significant activity in advanced ovarian epithelial neoplasms.
OBJECTIVE
To assess the activity of taxol in patients with advanced, progressive, and drug-refractory ovarian cancer and to delineate more clearly the toxicity of taxol in this patient population.


METHODS
Nonrandomized, prospective phase II trial.


METHODS
Forty-seven patients with drug-refractory epithelial ovarian cancer who had one or more lesions measurable in perpendicular diameters. Of these patients, 45 were evaluable for toxicity and 40 were evaluable for response.


METHODS
PATIENTS were treated every 22 days with varying doses of taxol (110 to 250 mg/m2 body surface) given as a 24-hour infusion with subsequent doses based on adverse effects. A premedication regimen was used to avoid acute hypersensitivity reactions.


RESULTS
Twelve patients (30%; CI, 16% to 44%) responded to taxol for periods lasting from 3 to 15 months. The dose-limiting toxicity was myelosuppression with leukocytes affected more severely and commonly than thrombocytes or reticulocytes. Leukopenia was usually brief in duration but was associated with sepsis in 3 cases (2 fatal). Other adverse effects included myalgias, arthralgias, alopecia, diarrhea, nausea, vomiting, mucositis, and peripheral neuropathy. Rare cases of cardiac and central neurotoxicity were also noted.


CONCLUSIONS
Taxol is an active agent in drug-refractory ovarian cancer and deserves further study in combination with other active drugs in previously untreated patients with advanced ovarian cancer.
McGuire
W P
WP
Johns Hopkins Oncology Center, Baltimore, Maryland.
Rowinsky
E K
EK
Rosenshein
N B
NB
Grumbine
F C
FC
Ettinger
D S
DS
Armstrong
D K
DK
Donehower
R C
RC
D000470:Alkaloids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced; D002945:Cisplatin / Q000009:adverse effects; D004341:Drug Evaluation; D004830:Epilepsy, Tonic-Clonic / Q000139:chemically induced; D005260:Female; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D007592:Joint Diseases / Q000139:chemically induced; D009135:Muscular Diseases / Q000139:chemically induced; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D017239:Paclitaxel; D010146:Pain / Q000139:chemically induced; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced
D000470:Alkaloids; D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel; D002945:Cisplatin