The use of paclitaxel and platinum-based chemotherapy in uterine papillaryserous carcinoma

Objective. Uterine papillary serous carcinoma (UPSC) is an aggressive malig nancy with a histologic appearance and pattern of spread that resembles tha t of papillary serous adenocarcinoma of the ovary. The current standard the rapy for advanced ovarian cancer, cisplatin or carboplatin plus paclitaxel, results in high objective response rates for that tumor. This regimen has thus far not been evaluated in UPSC. Methods. Twenty-four patients with UPSC treated with platinum-based chemoth erapy and paclitaxel were retrospectively evaluated. Eighteen patients rece ived these agents in the adjuvant setting (n = 9) or for disease persistent after initial surgical management (n = 9). Eleven patients received one or more courses of this drug combination for recurrent disease, 5 of whom had prior exposure in the initial setting. Results. Mean follow-up was 35 months (range 6-72+). A median progression-f ree interval (PFI) of 30 months (range 8-61+) was seen in patients treated in the adjuvant setting. Objective response, indicated by normalization of an elevated prechemotherapy CA125 level, was seen in 8 of 9 patients treate d for residual disease after initial surgery (median PFI of 13 months, rang e 5-38+). Objective response of both measurable and/or evaluable disease wa s seen in 7 of 11 patients treated for recurrent disease (median PFI of 9 m onths, range 4-18). Six patients had retreatment with one or both agents an d 4 responded a second time. Overall, the regimen was well tolerated. Conclusion. Paclitaxel and platinum-based chemotherapy has demonstrated act ivity in UPSC with acceptable toxicity. These results merit further investi gation of the possible role of these agents in patients with this aggressiv e histologic subtype. (C) 1999 Academic Press