GUNSTIG EFFECT VAN PACLITAXEL (TAXOL) BIJ PATIENTEN MET EEN MET PLATINA VOORBEHANDELD OVARIUMCARCINOOM

Objective: To assess the anti-tumour and side effects of paclitaxel in patients with ovarian carcinoma, after prior treatment with at least one platinum-containing chemotherapy regimen. Design: Phase II study. Setting: Academic Hospital of the Free University, Amsterdam. Method: Fourteen of 55 patients with progressive ovarian carcinoma were treated with 135 mg/m² and 41 with 175 mg/m² paclitaxel, 9 patients by 24-hour and 46 by 3-hour intravenous infusion. Results: In 9/55 (16%) patients an objective tumour response was obtained, which was complete in 1 patient. In 19/55 (35%) patients the disease stabilised. The serum CA 125 level was increased in 52 patients. In 33% of the patients the course of the serum CA 125 was an indication of the tumour response. The median duration of response was 8 months (range 4.1-13.1) and the median duration of survival was 11.3 months (range 0.3-28.2). Side effects of paclitaxel treatment were hair-loss, arthralgia and myalgia and neutropenia of short duration. In 76% of patients pre-existing neurosensory symptoms increased mildly or developed de novo. The neurotoxic effect appeared reversible in most instances after discontinuation of the paclitaxel treatment. Conclusion: In this rather unfavourable patient population, paclitaxel induced only 16% objective response. However, more than 50% of the patients did benefit from paclitaxel treatment, as a much larger group had long lasting disease stabilisation without symptoms or had reduction of symptoms. The treatment was well tolerated by most patients.