Salvage chemotherapy with paclitaxel for recurrent primary brain tumors.

Abstract

PURPOSE:

To assess the safety and efficacy of Taxol (paclitaxel; Bristol-Myers Squibb Co, Princeton, NJ) given at a dose of 175 mg/m2 every 3 weeks as a 3- to 4-hour outpatient infusion to patients with recurrent malignant primary brain tumors who had received prior radiotherapy and at least one chemotherapy regimen containing nitrosoureas and who were no longer responding to therapy.

PATIENTS AND METHODS:

Twenty patients (12 men and eight women), ages 19 to 69 years (median, 35), with recurrent primary brain tumors were treated according to a phase II protocol with intravenous Taxol. Tumor histologies included the following: anaplastic astrocytoma (n = 8), glioblastoma multiforme (n = 8), and anaplastic oligodendroglioma (n = 4). All patients had been previously treated with subtotal resection, limited-field radiotherapy (median dose, 60 Gy; range, 54 to 78 Gy), and nitrosourea-based chemotherapy. Taxol was administered intravenously at a dose of 175 mg/m2/d every 3 weeks with neurologic and neuroradiographic evaluation every 8 to 9 weeks. Complete blood cell counts were performed weekly.

RESULTS:

A median of six cycles of Taxol (range, two to 12) were administered to 20 assessable patients. Toxicities included partial alopecia (n = 10), thrombocytopenia (n = 4), rate of Taxol administration-dependent bradycardia (n = 3), and nondisabling peripheral neuropathy (n = 1). No patient developed neutropenic fever or sepsis or required cytokine support. Two patients required blood-product support (platelet transfusions in both). Four patients (20%) demonstrated a partial response (PR) and seven (35%) had stable disease (SD) for a total response plus SD rate of 55%. The median time to tumor progression was 6 months (range, 2 to 20).

CONCLUSION:

Taxol demonstrated modest efficacy with minimal toxicity in this heavily pretreated cohort of young patients with recurrent primary brain tumors.

• Authors: M C Chamberlain, P Kormanik
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 13 Issue 8 Pg. 2066-71 (Aug 1995) ISSN: 0732-183X [Print] United States
• PMID: 7636549 (Publication Type: Clinical Trial, Clinical Trial, Phase II, Journal Article)

Chemical References

• Paclitaxel

Topics

• Adult
• Aged
• Alopecia (chemically induced)
• Brain Neoplasms (drug therapy)
• Female
• Humans
• Male
• Middle Aged
• Neoplasm Recurrence, Local (drug therapy)
• Paclitaxel (administration & dosage, adverse effects, therapeutic use)
• Remission Induction
• Salvage Therapy
• Thrombocytopenia (chemically induced)