Journal of Clinical Oncology, Vol 16, 574-578, Copyright © 1998 by American Society of Clinical Oncology
Phase II trial of paclitaxel by 24-hour continuous infusion for relapsed non-Hodgkin's lymphomas: Southwest Oncology Group trial 9246
OW Press, M LeBlanc, TJ O'Rourke, S Gagnet, RA Chapman, SP Balcerzak and RI Fisher
University of Washington Cancer Center, USA. press@u.washington.edu
PURPOSE: The Southwest Oncology Group (SWOG) recently conducted a
multiinstitutional phase II trial to determine the complete response (CR)
and partial response (PR) rates, toxicities, and progression-free and
overall survivals of patients with relapsed non-Hodgkin's lymphomas (NHLs)
treated with a 24-hour continuous infusion of paclitaxel at a dose of 175
mg/m2. PATIENTS AND METHODS: Sixty-six patients with relapsed NHL who had
received minimal prior therapy (one prior chemotherapy regimen for
intermediate- to high-grade NHL [44 patients] or one or two prior regimens
for low-grade NHL [22 patients]) were premedicated with dexamethasone,
diphenhydramine, and cimetidine and then treated with continuous
intravenous infusion paclitaxel over 24 hours every 21 days. RESULTS:
Eleven of 66 patients (17%) achieved rigorously documented objective
remissions, including two CRs (3%) and nine PRs (14%). In addition, another
five patients (8%) achieved apparent PRs on a single computed tomographic
(CT) scan. Responses were brief, lasting a median of 3 months (5 months for
indolent lymphomas and 3 months for intermediate- to high-grade lymphomas).
Grade 4 or 5 granulocytopenia was the only common serious toxicity, and
occurred in 42 of 66 patients (64%). CONCLUSION: Paclitaxel is generally
well tolerated when given as a continuous infusion of 175 mg/m2 over 24
hours, despite predictable granulocytopenia. However, single-agent
paclitaxel has modest clinical efficacy compared with other available
treatments for relapsed NHL.
