CLINICAL ACTIVITY AND TOXICITY OF PACLITAXEL

Paclitaxel's activity has been demonstrated in advanced and refractory ovarian, breast and non small cell lung cancer (NSCLC) in phase I-II trials. To determine the toxicities and responses in clinical practise, paclitaxel was administered to 12 patients; 6 breast ca, 5 ovarian ca, 1 NSCLC. Paclitaxel doses of 210 mg/m2 in NSCLC and 150 mg/m2 in the other cancers were administered every three weeks by 6 hours continous infusion. Premedication with H2 antagonists, prednisolone, and pheniramine has been made 12 hours and 30 minutes before the paclitaxel infusion. Because of potencial hypersensivity reactions and occasional cardiac disturbances, vital signs (EKG, heart rate, pulmoner rate) were obtained during the administration. Leukocyte count monitoring was made between the cycles and when the leukocyte count fell below 3000/mm3, 5 mgr/kg GCSF was administered subcutaneusly. Toxicities of paclitaxel were evaluated by WHO grading system. In metastatic breast cancer 1 partial, 1 minimal (50%); in ovarian cancer 1 partial responses (25%) were observed. During the paclitaxel administration 4% grade II pulmonary, 4% grade II-III cardiac toxicities have been noted. None of the toxicities has prevented the application of the planned dose and time. Paclitaxel seems to be a well tolerated agent if patients receiving paclitaxel infusion have special preparation and monitoring in clinical conditions.