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Docetaxel and Cisplatin in First Line Treatment of Patients with Unknown Primary Cancer: A Multicenter Study of the Anatolian Society of Medical Oncology

  • Demirci, Umut (Department of Medical Oncology, Dr. A.Y. Ankara Oncology Training and Research Hospital) ;
  • Coskun, Ugur (Faculty of Medicine, Gazi University) ;
  • Karaca, Halit (Numune Training and Research Hospital) ;
  • Dane, Faysal (Faculty of Medicine, Marmara University) ;
  • Ozdemir, Nuriye Yildirim (Faculty of Medicine, Erciyes University) ;
  • Ulas, Arife (Ataturk Training and Research Hospital) ;
  • Baykara, Meltem (Sakarya University Training and Research Hospital) ;
  • Benekli, Mustafa (Faculty of Medicine, Gazi University) ;
  • Ozkan, Metin (Numune Training and Research Hospital) ;
  • Buyukberber, Suleyman (Faculty of Medicine, Gazi University)
  • Published : 2014.02.28

Abstract

Background: The overall prognosis for cancers of unknown primary (CUP) is poor, median overall survival (OS) being 6-12 months. We evaluated our multicentric retrospective experience for CUP administered docetaxel and cisplatin combination therapy. Materials and Methods: A total of 29 patients that were pathologically confirmed subtypes of CUP were included in the study. The combination of docetaxel ($75mg/m^2$, day 1) and cisplatin ($75mg/m^2$, day 1) was performed as a first line regimen every 21 days. Results: The median age was 51 (range: 27-68). Some 17 patients had multimetastatic disease on the inital diagnosis. Histopathological diagnoses were well-moderate differentiated adenocarcinoma (51.7%), undifferentiated carcinoma (27.6%), squamous cell cancer (13.8%), mucoepidermoid carcinoma (3.4%) and neuroendocrine differentiated carcinoma (3.4%). Median number of cycles was 3 (range: 1-6). Objective response rate was 37.9% and clinical benefit was 58.6%. Median progression free survival (PFS) and overall survival (OS) were 6 months (range: 4.3-7.7 months) and 16 months (range: 8.1-30.9 months), respectively. Fourteen patients (60.8%) were treated in a second line setting. There was no treatment related death. Most common toxicities were nausia-vomiting (44.6%) and fatigue (34.7%), serious cases (grade 3/4) suffering nausia-vomiting (10.3%), neutropenia (13.8%) and febrile neutropenia (n=1). Conclusion: The combination of cisplatin and docetaxel is an effective regimen for selected patients with CUP.

Keywords

Cancer of unknown primary;docetaxel;cisplatin;combination;clinical benefit

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