A Phase II trial of docetaxel and cisplatin in patients with recurrent or metastatic nasopharyngeal carcinoma

Abstract 

A Phase II study was conducted to determine the efficacy and toxicity of the combination of docetaxel and cisplatin, in patients with recurrent or metastatic nasopharyngeal carcinoma (NPC). Nine patients (median age 39 years) with NPC were enrolled, none had prior chemotherapy for their recurrent or metastatic disease. Docetaxel was administered as a 1-h intravenous infusion at a dose of 75 mg/m² on day 1; cisplatin was administered at a dose of 75 mg/m² on day 1, immediately after docetaxel. Treatment was repeated every 3 weeks. The primary endpoint was objective response rate and the secondary endpoints were duration of response, time to progression, and overall survival. A total of 45 chemotherapy cycles were administered. In an intention-to-treat analysis two patients (22%, 95% confidence interval (CI): 3–60%) achieved a partial response. The median duration of response was 4.1 months, the median time to progression 8.4 months and the overall survival at 1 year from start of treatment was 76%. Grade 3–4 neutropenia was observed in all (100%) patients over 93% of the treatment cycles, and in three cases this was complicated by fever. Other toxicities were mild. Conclusions: The combination of docetaxel and cisplatin has manageable toxicity but little efficacy as first-line treatment in patients with recurrent or metastatic NPC. In view of the low response rate, accrual was terminated and the trial was aborted.

Keywords:  NPC, Cisplatin, Docetaxel, Recurrent, Metastatic