PACLITAXEL (TAXOL(R)) FOR THE TREATMENT OF LYMPHOMA

Paclitaxel (Taxol(R)) was recently tested in patients with relapsed an d refractory lymphoma in two phase II clinical trials using two differ ent infusion schedules. The first, reported from the NCI (USA), used a 96-hour intravenous continuous infusion schedule, and the second, fro m our group, used a 3-hour infusion. In the NCI trial, 29 evaluable pa tients were treated with 140 mg/m(2) every three weeks, which achieved a 17% response rate (all PRs); while we treated 96 evaluable patients with 200 mg/m(2) every three weeks, which achieved a 25% response rat e (10 CRs and 14 PRs, 95% CI: 17%-35%). In our trial, patients with re lapsed (not primary refractory) intermediate-grade lymphoma had a resp onse rate of 50%, and those with relapsed low-grade lymphoma had a res ponse rate of 31%. In a follow-up trial, 12 patients who failed to res pond to 3-hour infusion of paclitaxel were crossed over to receive pac litaxel by 96-hour infusion. None of the 12 evaluable patients achieve d a major clinical response. Similarly, of 25 patients treated with cy closporine A and paclitaxel after failing therapy with single-agent pa clitaxel, only one patient (4%) responded. We conclude that paclitaxel has a promising single-agent activity: most prominently in patients w ith relapsed intermediate-grade lymphoma. Paclitaxel-based combination programs are currently being evaluated in our institution.