Current and future trials of Taxol (paclitaxel) in head and neck cancer.
Phase II clinical trials of single-agent paclitaxel have demonstrated the drug's activity in ovarian cancer, breast cancer, and both small cell and non-small cell lung cancer. A recently completed trial in recurrent head and neck cancerpatients conducted by the Eastern Cooperative Oncology Group resulted in a 40% (12 of 30) overall (complete plus partial) response rate with a high dose of paclitaxel (250 mg/m2 by 24-hour continuous infusion) and granulocyte colony-stimulating factor support. Responses were observed in previously irradiated sites of locoregional disease as well as in distant metastases. The major toxicities were brief grade 3-4 neutropenia occurring in 91%, peripheral neuropathy in 39%, and arthralgias/myalgias in 39% of treated patients. Confirmatory single-agent trials with paclitaxel are in progress in the United States and Europe. Phase I and II trials also in progress or planned combine paclitaxel with cisplatin or carboplatin; ifosfamide; methotrexate; and cisplatin/5-fluorouracil. Lower doses (135 to 175 mg/m2) and alternative infusion schedules ranging from 3 hours to 10 days are also under evaluation in head and neck cancer and other solid tumors. Studies combining paclitaxel and radiotherapy are reviewed as well.
Forastiere
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Johns Hopkins Oncology Center, Baltimore, Maryland.
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000532:radiotherapy / Q000556:secondary; D017322:Clinical Trials, Phase II as Topic; D003131:Combined Modality Therapy; D005544:Forecasting; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000532:radiotherapy; D017239:Paclitaxel / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
D017239:Paclitaxel