UNKNOWN PRIMARY: ADENOCARCINOMA

 

Regimen/Number

Of Patients

Drug Dose and Route

Leukopenia/

Neutropenia

Toxicity

Anemia

Toxicity

Other

Grade III-IV Toxicities

Emetogenic

Potential

Consequences of

Adverse Event(s)

FAM

(Goldberg RM, et al.

J Clin Oncol

1986;4:395-99)

 

N= 43

 

5 – Fluorouracil 600mg/m2 IV days 1, 8, 29, 36

Doxorubicin 30 mg/m2 IV days 1, 29

Mitomycin 10 mg/m2 IV day 1

Repeat cycle every 8 weeks

Leukopenia

Grade III-IV 7%

 

 

Neutropenic Sepsis  5 %

Thrombocytopenia 12 %

Mucositis (Grade II-III) 7%

 

Day 1 –

Leve 4

Day 8 –

Level 2

Day 29 –

Level 4

Day 36 –

Level 2

Infection mortality 2%

Cardiac mortality 2 %

 

 

Gemcitabine

Carboplatin

Paclitaxel

(Greco FA, et al,

J  Clin Oncol,

2002;20:1651-56)

 

N= 120

 

Gemcitabine 1000 mg/m2 IV days 1, 8

Carboplatin targeted by the Calvert equation

to AUC of 5, day 1

Paclitaxel 200 mg/m2 IV over 1 hour day 1

Repeat cycle every 21 days

Appropriate premedications listed in Seciton 2,

Commonly Used Premedicaiton Regimens

 

Leukopenia

Grade III 28 %

Grade IV 4 %

 

GradeIII-IV 10%

Fevrile Neutropenia 10 %

Thrombocytopenia 14%

Fatigue 18 %

Arthralgia 7 %

Peripheral Neutropathy 7 %

Nausea / Vomiting  6%

Hypersensitivity 2 %

Day 1 –

Level 5

Day 8 –

Level 2

1 treatment-related

death due to sepsis

 

 

 

Paclitaxel

Carboplatin

Etoposide

(hainsworth JD, et al.

J Clin Oncol

1997;15:2385-93)

 

N= 55

 

 

Paclitaxel 200 mg/m2 IV

over1 hour, day 1, followed by

Carboplatin dose targeted by

Calvert equation to AUC of 6 IV day 1

Etoposide 50 mg/ d PO alternated with

100 mg/d PO days 1 – 10

Repeat cycle every 21 days

Appropriate premedications listed in Section2,

Commonly Used Premedication Regimens

Leukopenia

Grade III 56%

Grade IV 20 5

 

 

Nausea/Vomiting 9 %

Thrombocytopenia 26%

Peripheral neuropathy

(Grade III) 7 %

Hypersensitivity

(Grade IV ) 2 %

Fatigue ( Grade III) 7 %

Arthralgia/Myalgia

(Grade III) 2 %

 

Day 1 –

Level 5

Days 2 -10-

Level 2

Discontinued

treatment 4 %

Decreased dose 40 %

RBC transfusion 38 %

Hospitalization for febrile

neutropenia 13 %