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Combination Therapy Effective in Treating Patients With Carcinoma of Unknown Primary Site: Presented at ASCO

By Ed Susman

CHICAGO, IL -- June 5, 2003 -- More than half of patients treated with a combination of gemcitabine and carboplatin for metastatic carcinoma of unknown primary site received clinical benefit from the therapy, researchers reported here June 4^th at the 39^th Annual Meeting of the American Society of Clinical Oncology.

"In the 32 currently evaluable patients with carcinoma of unknown primary site, the regimen achieved a response rate of 25%, with 62.5% achieving overall disease stabilisation," said Kenneth Pittman, MD, an oncologist at The Queen Elizabeth Hospital, in Adelaide, South Australia.

During a poster presentation, Dr. Pittman noted that between 5% and 10 % of all cancer diagnoses are listed as carcinoma of unknown primary site -- and most of those cancers are adenocarcinomas.

The ongoing phase II trial-- the Adelaide Cancer Trials and Education Collaborative -- enrolled 18 men and 19 women, with an average age of 69 (range 43-83). Metastases seen among these patients were in the liver in 58%, lung in 28%, pleura in 17%, peritonaeum in 17%; abdomen or pelvic nodes in 17%, and bone in 11%.

Eight patients achieved documented partial responses, including one 75-year-old man with liver metastases who had disease progression for 85 weeks.

Dr. Pittman said that the combination of gemcitabine and carboplatin was selected for these patients because the therapy is know to be effective against several tumour types and that the regimen is generally well tolerated.

Of the 138 cycles analysed for toxicity by the researchers, 35 cycles required some delay, primarily due to development of cytopenia. He said that 7 of the 32 patients experienced grade 3 or grade 4 toxicity, and sepsis may have contributed to the death of 1 patient. The main adverse, high-grade toxicities were thrombocytopenia, anaemia, and nausea/vomiting.

"The median overall survival of approximately 6 months compares favourably with other studies of chemotherapy in carcinoma of unknown primary site," Dr. Pittman said, "most of which have studied cohorts with a median age 10 years younger than in this study." He said that a quality of life analysis is being performed.

The study received funding support from Eli Lilly Australia.


[Study title: Phase II Study of Gemcitabine and Carboplatin as Combination Therapy for Patients With Metastatic Carcinoma of Unknown Primary Site (CUP): Preliminary Results. Abstract 3074]

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