Paclitaxel and carboplatin vs gemcitabine and vinorelbine in patients with adeno- or undifferentiated carcinoma of unknown primary: a randomised prospective phase II trial
2009

Comparing Chemotherapy Regimens for Unknown Primary Cancer

Sample size: 92 publication Evidence: moderate

Author Information

Author(s): G Huebner, H Link, C H Kohne, M Stahl, A Kretzschmar, S Steinbach, G Folprecht, H Bernhard, S E Al-Batran, P Schoffski, C Burkart, F Kullmann, B Otremba, M Menges, M Hoffmann, U Kaiser, A Aldaoud, A Jahn

Primary Institution: Westpfalz-Klinikum, Germany

Hypothesis

Does the combination of paclitaxel and carboplatin provide better outcomes than gemcitabine and vinorelbine in patients with carcinoma of unknown primary?

Conclusion

The paclitaxel/carboplatin regimen showed clinically meaningful activity compared to gemcitabine/vinorelbine in patients with carcinoma of unknown primary.

Supporting Evidence

  • Paclitaxel/carboplatin showed a practicability rate of 52.4%.
  • Gemcitabine/vinorelbine had a practicability rate of 42.2%.
  • The median overall survival was 11.0 months for paclitaxel/carboplatin and 7.0 months for gemcitabine/vinorelbine.
  • Response rates were 23.8% for paclitaxel/carboplatin and 20.0% for gemcitabine/vinorelbine.

Takeaway

Doctors tested two types of chemotherapy to see which one works better for patients with cancer that doesn't have a known starting point. One type worked better than the other.

Methodology

Patients were randomized to receive either paclitaxel/carboplatin or gemcitabine/vinorelbine, with the primary endpoint being the rate of practicability defined by treatment cycles and survival.

Potential Biases

Selection bias may have influenced the results due to the heterogeneity of the disease.

Limitations

The study included a high-risk population, and no complete remissions were observed.

Participant Demographics

Patients aged 18-80 with histologically/cytologically proven adeno- or undifferentiated metastatic CUP.

Statistical Information

Confidence Interval

95% CI 36–68% for arm A; 95% CI 28–58% for arm B

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1038/sj.bjc.6604818

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