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| |  DG DISPATCH - ICACT: Neurotoxicity Decreased With Paclitaxel Split-Dose Regimen By Jill Klein Special to DG News
PARIS, FRANCE -- February 1, 2000 -- French investigators have identified a method that seems to be helpful in reducing neurotoxicity in patients with advanced ovarian cancer who are treated with a combination of carboplatin-paclitaxel.
Neurotoxicity is the main dose-limiting toxicity associated with the use of paclitaxel. Investigators from the Hotel-Dieu Hospital in Paris found that giving half the conventional dose of paclitaxel on one day and the other half one week later decreased peripheral neuropathy in women with advanced ovarian cancer who had developed moderate to severe neuropathy with the standard paclitaxel-carboplatin regimen. Paclitaxel is typically given at a dose of 175 mg/m2 as a three-hour infusion. Dr. Gaeton Des Guetz, with the hemaology/oncology division, reported the results at the 10th International Congress on Anti-Cancer Chemotherapy (ICACT). The trial included ten patients with histologically confirmed advanced ovarian cancer with a median age of 64 years who received paclitaxel in two split doses (85 mg/m2) administered as two one-hour infusions one week apart. Carboplatin was given at its usual dose on day one, and the cycle was repeated on day 21. Fifty cycles of the new schedule were administered, with a mean of six cycles per patient. All patients enrolled in the trial had developed severe peripheral sensory neuropathy during prior treatment with paclitaxel and carboplatin. Neuropathy remained stable with the new regimen in 16 percent of cycles and improved in 94 percent of cycles, Dr. Des Guetz said. While patients were only able to tolerate 30 cycles when the total cycle was given on day one, they were able to tolerate 50 additional cycles with the split regimen. Other toxicities were also reduced with the split regimen. These included severe neutropenia, neutropenia with fever, severe thrombocytopenia, and arthralgia and myalgia. All ten patients had lost their hair during conventional treatment but six patients had some regrowth on both treatment days with the split-dose regimen. Dr. Des Guetz said that a much larger, randomized trial will be needed to determine whether or not paclitaxel's efficacy is maintained with the split-dose regimen. Related Links: paclitaxel (Taxol) and Carboplatin.
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