Bortezomib, paclitaxel, and carboplatin as a first-line regimen for patients with metastatic esophageal, gastric, and gastroesophageal cancer: phase II results from the North Central Cancer Treatment Group (N044B).
OBJECTIVE
This study was undertaken to explore the response rate of a first-line, three-drug regimen that consisted of bortezomib, paclitaxel, and carboplatin in patients with metastatic adenocarcinoma of the esophagus, gastroesophageal junction, or gastric cardia.


METHODS
Patients with the above diagnosis and acceptable organ function were treated intravenously on a 21-day cycle with the following: bortezomib 1.2 mg/m on days 1, 4, and 8; paclitaxel 175 mg/m on day 2; and carboplatin with an area under the curve of 6 on day 2. Patients received indefinite treatment unless they manifested tumor progression or severe adverse events. All were monitored for tumor response as well as other clinical outcomes.


RESULTS
The cohort included 35 eligible patients with a median age of 59 years (range, 36-78) and an Eastern Cooperative Oncology Group performance score of 0, 1, and 2 in 60%, 34%, and 6% of patients, respectively. Although this regimen was well tolerated, the tumor response rate was lower than that anticipated at 23% (95% confidence interval: 10%, 40%), thereby prompting premature study closure. There were no complete responses. The median survival for the cohort was 8.9 months (95% confidence interval: 5.9, 12.8).


CONCLUSIONS
As prescribed in this trial and for this indication, this regimen does not merit further testing.
Jatoi
Aminah
A
Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA. Jatoi.aminah@mayo.edu
Dakhil
Shaker R
SR
Foster
Nathan R
NR
Ma
Cynthia
C
Rowland
Kendrith M
KM
Moore
Dennis F
DF
Jaslowski
Anthony J
AJ
Thomas
Sachdev P
SP
Hauge
Mark D
MD
Flynn
Patrick J
PJ
Stella
Philip J
PJ
Alberts
Steven R
SR
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001897:Boronic Acids / Q000008:administration & dosage; D000069286:Bortezomib; D016190:Carboplatin / Q000008:administration & dosage; D002299:Cardia / Q000473:pathology; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000556:secondary; D004943:Esophagogastric Junction / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D011719:Pyrazines / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000556:secondary; D015996:Survival Rate; D016896:Treatment Outcome
D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib; D016190:Carboplatin; D017239:Paclitaxel