Paclitaxel efficacy and tolerability in second-line treatment of refractory and relapsed ovarian cancer patients

Nineteen patients with recurrent or refractory ovarian carcinoma after a fi rst-line platinum-based chemotherapy were treated with a 3-hour i.v. infusi on of paclitaxel 175 mg/m(2) every 3 weeks from November 1992 to October 19 96. The major hematologic toxicity was neutropenia (63.2%). No febrile neut ropenia was observed. Other hematologic effects were leukopenia (47.4%) and anemia (47.4%). The main non-hematologic toxicities were as follows: neuro pathy (52.6%), nausea and vomiting (36.8%), myalgia (36.8%), cardiac toxici ty (15.8%) and mucositis (10.5%). Alopecia was observed in the majority of cases. The overall response rate was 47.4%, with 5 (26.3%) complete respons es (CRs) and 4 (21.1%) partial responses (PRs). The median duration of resp onse was 7 months (range: 3-19), with a median follow-up of 17 months (rang e: 3-61). Quality of life of responding patients was good. Our results conf irm that paclitaxel as second-line therapy in relapsed and refractory ovari an cancer patients is an acceptable treatment with a good safety profile, a nd can be safely administered at the dose of 175 mg/m2. In our study paclit axel was more active in relapsed than in refractory patients. Consequently, further studies are needed to identify more effective drugs for the refrac tory subset.