Paclitaxel and
carboplatin are commonly used and well-tolerated agents for gynecologic
malignancies. The persistence of
platinum in human tissues for 14 days and the long-term retention of
platinum in tissues for up to 17 months have been reported.
Paclitaxel remains in human
uterine cervical cancer tissues for 6 days. These findings prompted us to determine the retention of
paclitaxel and
carboplatin in human uterine cervical
carcinoma, endometrial carcinoma, ovarian
carcinoma, and pelvic lymph nodes to establish baseline parameters and guide the development of more effective treatment interventions. Thirty patients with uterine or ovarian
carcinomas were treated with intravenous weekly
paclitaxel-
carboplatin chemotherapy before surgery. The concentrations of these agents in
carcinoma tissue, normal cervical, myometrial and ovarian tissues, and pelvic lymph nodes were measured 5 days after the final administration.
Paclitaxel was specifically retained in cervical, endometrial, and ovarian
carcinoma tissues but was not detected in lymph nodes. In contrast to
paclitaxel,
carboplatin was readily detectable with similar levels in all
tumor-associated and normal host tissues. In addition, a low
paclitaxel concentration in cervical
carcinoma tissue was significantly associated with short progression-free survival and overall survival. Further studies are needed to clarify the tissue distribution of anticancer drugs in humans and promote optimal treatment strategies enhancing
paclitaxel lymphatic targeting.