Phase II trial of docetaxel and carboplatin in patients with advanced squamous carcinoma of the esophagus (E2298): A trial of the eastern cooperative oncology group

Joanne F. Rossman, Carla I. Falkson, Ronghui Xu, Coenraad F. Slabber, Bernard A. Mason, Mary Frances Mulcahy, Al B Benson III

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Occasional complete responses have been reported in patients with squamous-cell carcinoma of the esophagus treated with carboplatin, and the inferior outcomes seen in early studies might have been the result of underdosing using BSA calculations. Docetaxel was reported to have single-agent activity in squamous-cell carcinoma of the esophagus, with a 50% response rate in a pilot study performed in South Africa. Thus, ECOG investigated the potential role of combination carboplatin using AUC-based dosing and docetaxel in patients with squamous-cell carcinoma of the esophagus. Patients and Methods: ECOG 2298 was a multicenter, international, phase II clinical study of docetaxel and carboplatin in patients with histologically confirmed, measurable squamous-cell carcinoma of the esophagus. Docetaxel 75 mg/m2 was infused over 1 hour on day 1 of each cycle. The carboplatin dose was calculated to an AUC of 6 and infused over 15-30 minutes immediately after the docetaxel. The regimen was repeated every 3 weeks for a total of 6 cycles or until disease progression occurred or unacceptable toxicity developed. Results: A total of 32 patients were accrued, mostly men (78%) with a median age of 64 (range, 41-86). Half the patients were black and half were white. Five patients were not evaluable due to protocol violations. Of the remaining 27 patients, one (3%) achieved a complete clinical response. Four others (13%) achieved partial responses. Thirteen (41%) had stable disease and 9 (28%) had progression of disease. Overall objective response rate was 15.6% (95% CI 5.9% to 36%). The most common grade 3 and 4 toxicities were leukopenia (25/32=78%) and neutropenia (27/32=84%). Most nonhematologic toxicities were infrequent and ≤ grade 3; however, two patients experienced grade 5 toxicities; one died of bowel obstruction and another died of infection with grade 4 neutropenia. Conclusions: The high toxicity and poor efficacy shown in this study suggest that the combination of carboplatin and docetaxel in squamous- cell carcinoma of the esophagus should not be investigated further. Newer agents need to be investigated in this malignancy.

Original languageEnglish (US)
Pages (from-to)9-14
Number of pages6
JournalGastrointestinal Cancer Research
Volume4
Issue number1
StatePublished - Jan 1 2011

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docetaxel
Carboplatin
Esophagus
Squamous Cell Carcinoma
Neutropenia
Area Under Curve
Disease Progression
Leukopenia
South Africa

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

Cite this

@article{b82469d9747d47d6b6a792adbe718486,
title = "Phase II trial of docetaxel and carboplatin in patients with advanced squamous carcinoma of the esophagus (E2298): A trial of the eastern cooperative oncology group",
abstract = "Background: Occasional complete responses have been reported in patients with squamous-cell carcinoma of the esophagus treated with carboplatin, and the inferior outcomes seen in early studies might have been the result of underdosing using BSA calculations. Docetaxel was reported to have single-agent activity in squamous-cell carcinoma of the esophagus, with a 50{\%} response rate in a pilot study performed in South Africa. Thus, ECOG investigated the potential role of combination carboplatin using AUC-based dosing and docetaxel in patients with squamous-cell carcinoma of the esophagus. Patients and Methods: ECOG 2298 was a multicenter, international, phase II clinical study of docetaxel and carboplatin in patients with histologically confirmed, measurable squamous-cell carcinoma of the esophagus. Docetaxel 75 mg/m2 was infused over 1 hour on day 1 of each cycle. The carboplatin dose was calculated to an AUC of 6 and infused over 15-30 minutes immediately after the docetaxel. The regimen was repeated every 3 weeks for a total of 6 cycles or until disease progression occurred or unacceptable toxicity developed. Results: A total of 32 patients were accrued, mostly men (78{\%}) with a median age of 64 (range, 41-86). Half the patients were black and half were white. Five patients were not evaluable due to protocol violations. Of the remaining 27 patients, one (3{\%}) achieved a complete clinical response. Four others (13{\%}) achieved partial responses. Thirteen (41{\%}) had stable disease and 9 (28{\%}) had progression of disease. Overall objective response rate was 15.6{\%} (95{\%} CI 5.9{\%} to 36{\%}). The most common grade 3 and 4 toxicities were leukopenia (25/32=78{\%}) and neutropenia (27/32=84{\%}). Most nonhematologic toxicities were infrequent and ≤ grade 3; however, two patients experienced grade 5 toxicities; one died of bowel obstruction and another died of infection with grade 4 neutropenia. Conclusions: The high toxicity and poor efficacy shown in this study suggest that the combination of carboplatin and docetaxel in squamous- cell carcinoma of the esophagus should not be investigated further. Newer agents need to be investigated in this malignancy.",
author = "Rossman, {Joanne F.} and Falkson, {Carla I.} and Ronghui Xu and Slabber, {Coenraad F.} and Mason, {Bernard A.} and Mulcahy, {Mary Frances} and {Benson III}, {Al B}",
year = "2011",
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volume = "4",
pages = "9--14",
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Phase II trial of docetaxel and carboplatin in patients with advanced squamous carcinoma of the esophagus (E2298) : A trial of the eastern cooperative oncology group. / Rossman, Joanne F.; Falkson, Carla I.; Xu, Ronghui; Slabber, Coenraad F.; Mason, Bernard A.; Mulcahy, Mary Frances; Benson III, Al B.

In: Gastrointestinal Cancer Research, Vol. 4, No. 1, 01.01.2011, p. 9-14.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Phase II trial of docetaxel and carboplatin in patients with advanced squamous carcinoma of the esophagus (E2298)

T2 - A trial of the eastern cooperative oncology group

AU - Rossman, Joanne F.

AU - Falkson, Carla I.

AU - Xu, Ronghui

AU - Slabber, Coenraad F.

AU - Mason, Bernard A.

AU - Mulcahy, Mary Frances

AU - Benson III, Al B

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Background: Occasional complete responses have been reported in patients with squamous-cell carcinoma of the esophagus treated with carboplatin, and the inferior outcomes seen in early studies might have been the result of underdosing using BSA calculations. Docetaxel was reported to have single-agent activity in squamous-cell carcinoma of the esophagus, with a 50% response rate in a pilot study performed in South Africa. Thus, ECOG investigated the potential role of combination carboplatin using AUC-based dosing and docetaxel in patients with squamous-cell carcinoma of the esophagus. Patients and Methods: ECOG 2298 was a multicenter, international, phase II clinical study of docetaxel and carboplatin in patients with histologically confirmed, measurable squamous-cell carcinoma of the esophagus. Docetaxel 75 mg/m2 was infused over 1 hour on day 1 of each cycle. The carboplatin dose was calculated to an AUC of 6 and infused over 15-30 minutes immediately after the docetaxel. The regimen was repeated every 3 weeks for a total of 6 cycles or until disease progression occurred or unacceptable toxicity developed. Results: A total of 32 patients were accrued, mostly men (78%) with a median age of 64 (range, 41-86). Half the patients were black and half were white. Five patients were not evaluable due to protocol violations. Of the remaining 27 patients, one (3%) achieved a complete clinical response. Four others (13%) achieved partial responses. Thirteen (41%) had stable disease and 9 (28%) had progression of disease. Overall objective response rate was 15.6% (95% CI 5.9% to 36%). The most common grade 3 and 4 toxicities were leukopenia (25/32=78%) and neutropenia (27/32=84%). Most nonhematologic toxicities were infrequent and ≤ grade 3; however, two patients experienced grade 5 toxicities; one died of bowel obstruction and another died of infection with grade 4 neutropenia. Conclusions: The high toxicity and poor efficacy shown in this study suggest that the combination of carboplatin and docetaxel in squamous- cell carcinoma of the esophagus should not be investigated further. Newer agents need to be investigated in this malignancy.

AB - Background: Occasional complete responses have been reported in patients with squamous-cell carcinoma of the esophagus treated with carboplatin, and the inferior outcomes seen in early studies might have been the result of underdosing using BSA calculations. Docetaxel was reported to have single-agent activity in squamous-cell carcinoma of the esophagus, with a 50% response rate in a pilot study performed in South Africa. Thus, ECOG investigated the potential role of combination carboplatin using AUC-based dosing and docetaxel in patients with squamous-cell carcinoma of the esophagus. Patients and Methods: ECOG 2298 was a multicenter, international, phase II clinical study of docetaxel and carboplatin in patients with histologically confirmed, measurable squamous-cell carcinoma of the esophagus. Docetaxel 75 mg/m2 was infused over 1 hour on day 1 of each cycle. The carboplatin dose was calculated to an AUC of 6 and infused over 15-30 minutes immediately after the docetaxel. The regimen was repeated every 3 weeks for a total of 6 cycles or until disease progression occurred or unacceptable toxicity developed. Results: A total of 32 patients were accrued, mostly men (78%) with a median age of 64 (range, 41-86). Half the patients were black and half were white. Five patients were not evaluable due to protocol violations. Of the remaining 27 patients, one (3%) achieved a complete clinical response. Four others (13%) achieved partial responses. Thirteen (41%) had stable disease and 9 (28%) had progression of disease. Overall objective response rate was 15.6% (95% CI 5.9% to 36%). The most common grade 3 and 4 toxicities were leukopenia (25/32=78%) and neutropenia (27/32=84%). Most nonhematologic toxicities were infrequent and ≤ grade 3; however, two patients experienced grade 5 toxicities; one died of bowel obstruction and another died of infection with grade 4 neutropenia. Conclusions: The high toxicity and poor efficacy shown in this study suggest that the combination of carboplatin and docetaxel in squamous- cell carcinoma of the esophagus should not be investigated further. Newer agents need to be investigated in this malignancy.

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