Results from a phase II study to assess the efficacy and tolerability of fulvestrant 250 mg/month as treatment of recurrent or metastatic endometrial carcinoma

5532

Background: Fulvestrant (F) is a pure anti-estrogen with no agonistic action and no known adverse effects on the endometrium. This may be an advantage over tamoxifen, which has been successfully used in the treatment of hormone-receptor (HR) positive recurrent or metastatic endometrial carcinoma. Methods: This was an open label single-arm multicentre phase II study (AGO-Uterus 5) in patients with recurrent or metastatic endometrial carcinoma and measurable disease (RECIST). Pts. received monthly 250 mg F i.m. injections. The primary objective was clinical response after 3 injections, measured 4 weeks after injection 3 (ITT-pop.). Safety and tolerability were secondary endpoints. Results: Between March 2003 and May 2006, 35 pts. were included. Mean age was 70 years (range 45–83), first diagnosis was a mean 2.6 years ago, diagnosis of recurrence 10.2 months ago. 25 pts. (73.5%) had a FIGO 4B; 24 pts. (71%) had endometrioid cancer, 5 (15%) serous and 5 other carcinoma. All pts. had a positive ER and/or PgR status. 1 pt. had received no surgery for her disease; 21 pts. (61.8%) had prior radiotherapy; 13 pts. (38.2%) chemotherapy. 26 pts. were assessed as planned (ITT); 5 pts. received fewer than 3 injections, 4 pts. were not seen 4 weeks after inj. 3. Response to F was PR in 5 pts. (19.2%) and SD in 8 pts. (30.8%), adding up to a 50% disease control rate. 13 pts. had PD. Tolerability was good, no previously unknown side effects occurred. Conclusions: F showed encouraging response rates in our patient collective and was well tolerated. Further studies are warranted with F in HR pos. endometrial carcinoma. This study was supported by AstraZeneca. F is licensed for treatment of ER+, advanced breast cancer after an antioestrogen in postmenopausal women.

[Table: see text]

Phase II study of weekly docetaxel in patients with recurrent or metastatic endometrial cancer: AGO Uterus-4

OBJECTIVE

The aim of this phase II multicenter study was to evaluate the safety, toxicity and efficacy of docetaxel administered weekly as first line chemotherapy in patients with recurrent or metastatic endometrial cancer.

PATIENTS AND METHODS

Thirty five patients with recurrent or metastatic endometrial cancer without previous chemotherapy were enrolled to receive three 6-week cycles of docetaxel 35 mg/m(2)/week with 2-week breaks between the cycles. Therapy response was evaluated after every 6-week cycle, and therapy was continued in case of at least stable disease. Final therapy response was evaluated after three 6-week cycles of docetaxel.

RESULTS

Thirty five patients with a median age of 65 years (range, 37-80 years) were evaluable for toxicity assessment, one patient presented with severe anaphylactic reaction during the second application of docetaxel and therapy was discontinued. Subsequently, this patient received doxorubicin-cisplatin combination chemotherapy. Another patient was initially documented with uterine papillary serous cancer but secondarily confirmed as uterine carcinosarcoma. Thus, 33 patients were assessable for response. Overall response rate was 21% (3 PR and 4 CR). Three patients showed stable disease. Median TTP and OAS were 12 weeks and 43 weeks, respectively. Therapy with weekly docetaxel was well tolerated; in particular, no grade 3 or 4 hematological toxicities occurred.

CONCLUSION

Docetaxel weekly has a favorable toxicity profile, is well tolerated and shows encouraging activity in patients with advanced endometrial cancer.