NO EFFECT OF 96-HOUR PACLITAXEL INFUSION IN PATIENTS WITH RELAPSED NON-HODGKINS-LYMPHOMA REFRACTORY TO A 3-HOUR INFUSION SCHEDULE

Purpose: Preclinical data suggest that the efficacy of paclitaxel(Taxo l; Bristol-Myers Squibb Co, Princeton, NJ) is schedule-dependent. Sche dule dependency is currently under investigation in ongoing randomized trials. Patients and Methods: Twelve patients with relapsed non-Hodgk in's lymphoma (NHL) refractory to a 3-hour infusion of 200 mg/m(2) Tax ol were crossed over to receive a 96-hour infusion of 140 mg/m(2) Taxo l every 3 weeks in an outpatient setting. Premedication with corticost eroids and antihistamines was not used. Patients who did not achieve a t least a partial remission (PR) after two courses or whose disease pr ogressed after one course were removed from the study. Results: All 12 patients were assessable for response. Eleven patients received at le ast two courses and one patient received one course of 96-hour Taxol i nfusion. None of the 12 patients crossed over to receive 96-hour Taxol infusion achieved a PR or complete response (CR). Eight patients (67% ) developed progressive lymphoma, three (25%) had stable disease, and only one (8%) had a minor response. No major hypersensitivity reaction s or life-threatening toxicities were observed. Conclusion: Ninety-six -hour Taxol infusion does not produce suffficant responses in patients with NHL refractory to 3-hour Taxol infusion. Until the results of an ongoing multicenter trial comparing a 3- with a 96-hour infusion are published, the use of 96-hour Taxol infusion in NHL patients should be restricted to investigational programs. Because 48- to 72-hour infusi ons can produce higher plasma concentrations of Taxol than a 96-hour i nfusion, these schedules should be investigated to determine if they c an induce better clinical responses. (C) 1996 by American Society of C linical Oncology.