A phase II study of docetaxel in patients with metastatic carcinoid tumors.
Twenty-one patients with metastatic carcinoid tumors were treated with docetaxel. Although the treatment was well tolerated, no objective radiologic responses were observed. Novel, more effective agents are needed for this disease.


BACKGROUND
Traditional combination chemotherapy regimens containing streptozocin, doxorubicin, and 5-fluorouracil have yielded disappointing results in patients with metastatic carcinoid tumors. The lack of efficacy of these combinations, together with their toxicity, has led to efforts to investigate therapeutic agents that are potentially more active and tolerable. We, therefore, assessed the efficacy of docetaxel in the treatment of patients with metastatic carcinoid tumors.


METHODS
Twenty-one patients with metastatic carcinoid tumors were treated with docetaxel, administered at a dose of 75 mg/m2 every three weeks. Patients were followed for evidence of toxicity, response, and survival.


RESULTS
Docetaxel was well tolerated in this patient population. However, no objective radiologic responses were noted in any of the 21 patients. Of the 13 patients who were evaluable for biochemical responses to therapy, four (31%) experienced decreases in 24-hour urinary 5-hydroxyindole acetic acid (5HIAA) excretion of greater than 50%. The clinical course of the patients enrolled in this study was marked by a high incidence of radiologically stable disease (81%), a median progression-free survival time of 10 months, and a median overall survival time of 24 months.


CONCLUSIONS
Although treatment with docetaxel results in biochemical responses in patients with metastatic carcinoid tumors, the lack of more significant antitumor activity demonstrates the need for novel, more effective agents in this disease.
Kulke
Matthew H
MH
Department of Adult Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA. matthew_kulke@dfci.harvard.edu
Kim
Haesook
H
Stuart
Keith
K
Clark
Jeffrey W
JW
Ryan
David P
DP
Vincitore
Michele
M
Mayer
Robert J
RJ
Fuchs
Charles S
CS
D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002276:Carcinoid Tumor / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary / Q000652:urine; D018572:Disease-Free Survival; D000077143:Docetaxel; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000652:urine; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000652:urine; D015993:Life Tables; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000652:urine; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000008:administration & dosage; D011859:Radiography; D016879:Salvage Therapy; D016019:Survival Analysis; D043823:Taxoids / Q000008:administration & dosage / Q000627:therapeutic use*; D017211:Treatment Failure
D000972:Antineoplastic Agents, Phytogenic; D043823:Taxoids; D000077143:Docetaxel; D006897:Hydroxyindoleacetic Acid; D015282:Octreotide