Triplet combination of gemcitabine, paclitaxel, and carboplatin followed by maintenance 5-fluorouracil and folinic acid in patients with metastatic nasopharyngeal Carcinoma

Swan Swan Leong, Joseph Wee, Sandeep Rajan, Chee Keong Toh, Wan Teck Lim, Siew Wan Hee, Miah Hiang Tay, Donald Poon, Eng Huat Tan

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Abstract

BACKGROUND. Nasopharyngeal carcinoma (NPC) is a disease that is highly responsive to various chemotherapeutic agents. In the metastatic setting, 2-drug combination chemotherapy generally provides a response rate of 55% to 75%, and median survival of 10 to 12 months. The objective of the current study was to assess the efficacy of a 3-drug combination followed by maintenance treatment in patients with metastatic NPC. METHODS. Patients with metastatic NPC were treated with a combination of gemcitabine at a dose of 1000 mg/m2, paclitaxel at a dose of 70 mg/m2, and carboplatin at an area under the concentration-time-curve (AUC) of 2.5 on Days 1 and 8 every 21 days. Patients who achieved partial or complete response continued to receive weekly 5-fluorouracil at a dose of 450 mg/m2 and leucovorin at a dose of 30 mg/m2 for 48 weeks. RESULTS. Twenty-eight patients were recruited. Twenty-two (79%) patients had ≥2 sites of disease. Toxicities were mainly from bone marrow suppression, with 79% grade 3/4 neutropenia, 32% grade 3/4 anemia, and 29% grade 3/4 thrombocytopenia (according to the National Cancer Institute Common Toxicity Criteria). The overall response rate to the 3-drug regimen was 86%, with a complete response rate of 11%. The median duration of response was 8 months and the median overall survival was 22 months. CONCLUSIONS. This regimen of a 3-drug combination followed by maintenance is feasible and has demonstrated an encouraging response rate and overall survival.

Original languageEnglish (US)
Pages (from-to)1332-1371
Number of pages40
JournalCancer
Volume113
Issue number6
DOIs
StatePublished - Sep 15 2008
Externally publishedYes

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gemcitabine
Leucovorin
Carboplatin
Paclitaxel
Fluorouracil
Maintenance
Drug Combinations
Survival
National Cancer Institute (U.S.)
Combination Drug Therapy
Neutropenia
Anemia
Survival Rate
Bone Marrow
Nasopharyngeal carcinoma

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Triplet combination of gemcitabine, paclitaxel, and carboplatin followed by maintenance 5-fluorouracil and folinic acid in patients with metastatic nasopharyngeal Carcinoma. / Leong, Swan Swan; Wee, Joseph; Rajan, Sandeep; Toh, Chee Keong; Lim, Wan Teck; Hee, Siew Wan; Tay, Miah Hiang; Poon, Donald; Tan, Eng Huat.

In: Cancer, Vol. 113, No. 6, 15.09.2008, p. 1332-1371.

Research output: Contribution to journalArticle

Leong, Swan Swan ; Wee, Joseph ; Rajan, Sandeep ; Toh, Chee Keong ; Lim, Wan Teck ; Hee, Siew Wan ; Tay, Miah Hiang ; Poon, Donald ; Tan, Eng Huat. / Triplet combination of gemcitabine, paclitaxel, and carboplatin followed by maintenance 5-fluorouracil and folinic acid in patients with metastatic nasopharyngeal Carcinoma. In: Cancer. 2008 ; Vol. 113, No. 6. pp. 1332-1371.
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abstract = "BACKGROUND. Nasopharyngeal carcinoma (NPC) is a disease that is highly responsive to various chemotherapeutic agents. In the metastatic setting, 2-drug combination chemotherapy generally provides a response rate of 55{\%} to 75{\%}, and median survival of 10 to 12 months. The objective of the current study was to assess the efficacy of a 3-drug combination followed by maintenance treatment in patients with metastatic NPC. METHODS. Patients with metastatic NPC were treated with a combination of gemcitabine at a dose of 1000 mg/m2, paclitaxel at a dose of 70 mg/m2, and carboplatin at an area under the concentration-time-curve (AUC) of 2.5 on Days 1 and 8 every 21 days. Patients who achieved partial or complete response continued to receive weekly 5-fluorouracil at a dose of 450 mg/m2 and leucovorin at a dose of 30 mg/m2 for 48 weeks. RESULTS. Twenty-eight patients were recruited. Twenty-two (79{\%}) patients had ≥2 sites of disease. Toxicities were mainly from bone marrow suppression, with 79{\%} grade 3/4 neutropenia, 32{\%} grade 3/4 anemia, and 29{\%} grade 3/4 thrombocytopenia (according to the National Cancer Institute Common Toxicity Criteria). The overall response rate to the 3-drug regimen was 86{\%}, with a complete response rate of 11{\%}. The median duration of response was 8 months and the median overall survival was 22 months. CONCLUSIONS. This regimen of a 3-drug combination followed by maintenance is feasible and has demonstrated an encouraging response rate and overall survival.",
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T1 - Triplet combination of gemcitabine, paclitaxel, and carboplatin followed by maintenance 5-fluorouracil and folinic acid in patients with metastatic nasopharyngeal Carcinoma

AU - Leong, Swan Swan

AU - Wee, Joseph

AU - Rajan, Sandeep

AU - Toh, Chee Keong

AU - Lim, Wan Teck

AU - Hee, Siew Wan

AU - Tay, Miah Hiang

AU - Poon, Donald

AU - Tan, Eng Huat

PY - 2008/9/15

Y1 - 2008/9/15

N2 - BACKGROUND. Nasopharyngeal carcinoma (NPC) is a disease that is highly responsive to various chemotherapeutic agents. In the metastatic setting, 2-drug combination chemotherapy generally provides a response rate of 55% to 75%, and median survival of 10 to 12 months. The objective of the current study was to assess the efficacy of a 3-drug combination followed by maintenance treatment in patients with metastatic NPC. METHODS. Patients with metastatic NPC were treated with a combination of gemcitabine at a dose of 1000 mg/m2, paclitaxel at a dose of 70 mg/m2, and carboplatin at an area under the concentration-time-curve (AUC) of 2.5 on Days 1 and 8 every 21 days. Patients who achieved partial or complete response continued to receive weekly 5-fluorouracil at a dose of 450 mg/m2 and leucovorin at a dose of 30 mg/m2 for 48 weeks. RESULTS. Twenty-eight patients were recruited. Twenty-two (79%) patients had ≥2 sites of disease. Toxicities were mainly from bone marrow suppression, with 79% grade 3/4 neutropenia, 32% grade 3/4 anemia, and 29% grade 3/4 thrombocytopenia (according to the National Cancer Institute Common Toxicity Criteria). The overall response rate to the 3-drug regimen was 86%, with a complete response rate of 11%. The median duration of response was 8 months and the median overall survival was 22 months. CONCLUSIONS. This regimen of a 3-drug combination followed by maintenance is feasible and has demonstrated an encouraging response rate and overall survival.

AB - BACKGROUND. Nasopharyngeal carcinoma (NPC) is a disease that is highly responsive to various chemotherapeutic agents. In the metastatic setting, 2-drug combination chemotherapy generally provides a response rate of 55% to 75%, and median survival of 10 to 12 months. The objective of the current study was to assess the efficacy of a 3-drug combination followed by maintenance treatment in patients with metastatic NPC. METHODS. Patients with metastatic NPC were treated with a combination of gemcitabine at a dose of 1000 mg/m2, paclitaxel at a dose of 70 mg/m2, and carboplatin at an area under the concentration-time-curve (AUC) of 2.5 on Days 1 and 8 every 21 days. Patients who achieved partial or complete response continued to receive weekly 5-fluorouracil at a dose of 450 mg/m2 and leucovorin at a dose of 30 mg/m2 for 48 weeks. RESULTS. Twenty-eight patients were recruited. Twenty-two (79%) patients had ≥2 sites of disease. Toxicities were mainly from bone marrow suppression, with 79% grade 3/4 neutropenia, 32% grade 3/4 anemia, and 29% grade 3/4 thrombocytopenia (according to the National Cancer Institute Common Toxicity Criteria). The overall response rate to the 3-drug regimen was 86%, with a complete response rate of 11%. The median duration of response was 8 months and the median overall survival was 22 months. CONCLUSIONS. This regimen of a 3-drug combination followed by maintenance is feasible and has demonstrated an encouraging response rate and overall survival.

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