Gemcitabine and carboplatin in carcinoma of unknown primary site (CUP) in elderly patients: Analysis of a phase 2 Adelaide Cancer Trials and Education Collaborative (ACTEC) study
Date
2011
Authors
Bishnoi, S.
Pittman, K.
Yeend, S.
Brown, M.
Koczwara, B.
Kotasek, D.
Patterson, W.
Townsend, A.
Luke, C.
Price, T.
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Journal of Geriatric Oncology, 2011; 2(4):233-238
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S. Bishnoi, K. Pittman, S. Yeend, M.P. Brown, B. Koczwara, D. Kotasek, W.K. Patterson, A. Townsend, C. Luke and T.J. Price
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Abstract
Objective: Cancer of unknown primary site (CUP) remains a significant oncological problem for the elderly. Chemotherapy is the mainstay of treatment but the ideal regimen remains uncertain. We have performed a retrospective subset analysis of a previously reported prospective phase 2 trial evaluating efficacy and toxicity of the combination of gemcitabine (G) and carboplatin (C) in elderly patients with CUP. Materials and methods: In the original study, 51 patients with CUP, who had ECOG performance status (PS) 0-2, were treated with G 1000mg/m<sup>2</sup> iv days 1 and 8, and C AUC 5 iv day 8 every 3weeks to a maximum of 9 cycles. A subset of patients aged ≥65years were re-analysed for response rate, toxicity, progression-free survival (PFS) and overall survival (OS). These data were subsequently compared with the remaining patients aged <65years. Results: Data for 29 patients aged ≥ 65. years were compared with 22 patients aged < 65. years. For patients ≥ 65 years, response rate (RR) was 38%, median PFS was 20. weeks and median OS was 37. weeks. For patients < 65 years, RR was 14%, median PFS was 11. weeks and median OS was 33. weeks. The differences in PFS and OS were not statistically significant. Significant toxicity (predominantly myelosuppression) was recorded in 45% of patients ≥ 65 years and 32% in patients < 65 years, but was considered generally manageable for all patients. Conclusions: The GC regimen is active in CUP with excellent tolerability and should be considered for elderly patients with CUP. © 2011.
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Crown copyright © 2011 Published by Elsevier Ltd. All rights reserved