- In high-risk patients with advanced endometrial cancer, adjuvant docetaxel+cisplatin and paclitaxel+carboplatin showed similar survival vs standard doxorubicin+cisplatin.
- 3 regimens had different toxicity profiles.
- Hematologic toxicities were less frequent with taxane-based treatment.
- Gastrointestinal toxicities were more common with cisplatin regimen and neurotoxicity with paclitaxel+carboplatin.
Why this matters
- Based on toxicity profile, clinician can choose individualized treatment.
- Taxane-platinum regimens have previously shown efficacy in advanced or recurrent disease, but postoperative adjuvant use has not been assessed.
- Multicenter, phase 3 randomized Japanese Gynecologic Oncology Group study of 788 patients with high-risk early-stage or optimally debulked advanced endometrial cancer.
- Patients were randomly assigned to doxorubicin+cisplatin, docetaxel+cisplatin, or paclitaxel+carboplatin.
- Funding: Health Labour Sciences Research Grant.
- Median follow-up duration, 7 years.
- No statistical difference was observed between doxorubicin+cisplatin, docetaxel+cisplatin, paclitaxel+carboplatin in:
- 5-year PFS rate: 73.3%, 79.0%, and 73.9%, respectively (2-sided P=.12).
- 5-year OS rate: 82.7%, 88.1%, and 86.1%, respectively (2-sided P=.67).
- Leukopenia, neutropenia, febrile neutropenia, and anemia were less frequent with taxane-based regimen.
- Gastrointestinal toxicities were more common with cisplatin regimen.
- The incidence of neurotoxicity was higher with paclitaxel+carboplatin.
- Adverse-event-related discontinuations were more frequent with paclitaxel+carboplatin (12.2%) vs doxorubicin+cisplatin (6.5%) and docetaxel+cisplatin (5.7%).
- Open-label study.