Docetaxel for patients with paclitaxel-resistant Müllerian carcinoma.
OBJECTIVE
To determine the efficacy and toxicity of docetaxel in patients with müllerian carcinoma resistant to paclitaxel.


METHODS
Thirty-two patients with epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer who failed paclitaxel-based chemotherapy received either 100 or 75 mg/m(2) of docetaxel every 3 weeks. Resistance to paclitaxel was defined as either progression of disease during treatment, failure to achieve regression of disease after at least four courses, or rapid recurrence (within 6 months) after completion of therapy.


RESULTS
Eighteen patients were treated on a formal protocol and fourteen with the commercially available docetaxel. Thirty were assessable for response. Toxicities were thoroughly evaluated in the 18 patients on protocol. Twenty-seven patients (85%) had epithelial ovarian cancer. The overall response rate was 23% (one complete and six partial responses), with a median survival time of 44 weeks (9.5 months). Nine patients had stable disease and 14 progressive disease. Among 19 patients who progressed during prior paclitaxel treatment, two (11%) responded to docetaxel, compared with five (45%) of 11 patients in other paclitaxel-resistance categories. The responders had a median taxane-free interval (ie, the time between the last paclitaxel and first docetaxel treatment) of 73 weeks, compared with 19 weeks for the nonresponder group. Toxic effects were as expected.


CONCLUSIONS
Docetaxel is an active chemotherapeutic agent in patients with müllerian carcinoma previously treated with paclitaxel-based chemotherapy, especially in the patients who had a long taxane-free interval after a previous short response to paclitaxel.
Verschraegen
C F
CF
Departments of Internal Medicine Specialties and Biomathematics, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA. cverschr@mdanderson.org
Sittisomwong
T
T
Kudelka
A P
AP
Guedes
E d
Ed
Steger
M
M
Nelson-Taylor
T
T
Vincent
M
M
Rogers
R
R
Atkinson
E N
EN
Kavanagh
J J
JJ
D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D002277:Carcinoma / Q000188:drug therapy*; D000077143:Docetaxel; D019008:Drug Resistance, Neoplasm; D005185:Fallopian Tube Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D017239:Paclitaxel / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010534:Peritoneal Neoplasms / Q000188:drug therapy*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D043823:Taxoids
D000972:Antineoplastic Agents, Phytogenic; D043823:Taxoids; D000077143:Docetaxel; D017239:Paclitaxel