Docetaxel for patients with paclitaxel-resistant mullerian carcinoma

Purpose: To determine the efficacy and toxicity of docetaxel in patients with mullerian carcinoma resistant to paclitaxel. Patients and Methods: Thirty-two patients with epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer who failed paclitaxel-based chemotherapy received either 100 or 75 mg/m(2) of docetaxel every 3 weeks. Resistance to paclitaxel was defined as either progression of disease during treatment, failure to achieve regression of disease after at least four courses, or rapid recurrence (within 6 months) after completion of therapy. Results: Eighteen patients were treated on a formal protocol and fourteen with the commercially available docetaxel, Thirty were assessable for response. Toxicities were thoroughly evaluated in the 18 patients on protocol. Twenty-seven patients (85%) had epithelial ovarian cancer, The overall response rate was 23% tone complete and six partial responses), with a median survival time of 44 weeks (9.5 months), Nine patients had stable disease and 14 progressive disease. Among 19 patients who progressed during prior paclitaxel treatment two (11%) responded to docetaxel, compared with five (45%) of 11 patients in other paclitaxel-resistance categories. The responders had ct median taxane-free interval lie, the time between the last paclitaxel and first docetaxel treatment) of 73 weeks, compared with 19 weeks for the nonresponder group, Toxic effects were as expected. Conclusion: Docetaxel is an active chemotherapeutic agent in patients with mullerian carcinoma previously treated with paclitaxel-based chemotherapy, especially in the patients who had a long taxane-free interval after a previous short response to paclitaxel. (C) 2000 by American Society of Clinical Oncology.