Triplet combination of gemcitabine, paclitaxel, and carboplatin followed by maintenance 5-fluorouracil and folinic acid in patients with metastatic nasopharyngeal Carcinoma

Swan Swan Leong, Joseph Wee, Sandeep Rajan, Chee Keong Toh, Wan Teck Lim, Siew Wan Hee, Miah Hiang Tay, Donald Poon, Eng Huat Tan

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48 Scopus citations


BACKGROUND. Nasopharyngeal carcinoma (NPC) is a disease that is highly responsive to various chemotherapeutic agents. In the metastatic setting, 2-drug combination chemotherapy generally provides a response rate of 55% to 75%, and median survival of 10 to 12 months. The objective of the current study was to assess the efficacy of a 3-drug combination followed by maintenance treatment in patients with metastatic NPC. METHODS. Patients with metastatic NPC were treated with a combination of gemcitabine at a dose of 1000 mg/m2, paclitaxel at a dose of 70 mg/m2, and carboplatin at an area under the concentration-time-curve (AUC) of 2.5 on Days 1 and 8 every 21 days. Patients who achieved partial or complete response continued to receive weekly 5-fluorouracil at a dose of 450 mg/m2 and leucovorin at a dose of 30 mg/m2 for 48 weeks. RESULTS. Twenty-eight patients were recruited. Twenty-two (79%) patients had ≥2 sites of disease. Toxicities were mainly from bone marrow suppression, with 79% grade 3/4 neutropenia, 32% grade 3/4 anemia, and 29% grade 3/4 thrombocytopenia (according to the National Cancer Institute Common Toxicity Criteria). The overall response rate to the 3-drug regimen was 86%, with a complete response rate of 11%. The median duration of response was 8 months and the median overall survival was 22 months. CONCLUSIONS. This regimen of a 3-drug combination followed by maintenance is feasible and has demonstrated an encouraging response rate and overall survival.

Original languageEnglish (US)
Pages (from-to)1332-1337
Number of pages6
Issue number6
StatePublished - Sep 15 2008



  • Chemotherapy
  • Induction
  • Maintenance
  • Nasopharyngeal carcinoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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