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Annals of Oncology 5:543-547, 1994
© 1994 European Society for Medical Oncology

other

A phase II study of Gemcitabine (LY 188011) in patients with advanced squamous cell carcinoma of the head and neck

G. Catimel1,, J. B. Vermorken2, M. Clavel1, P. de Mulder3, I. Judson4, C. Sessa5, M. Piccart6, U. Bruntsch7, J. Verweij8, J. Wanders9, H. Franklin9, S. B. Kaye10 and For the EORTC Early Clinical Trials Group

1Centre Léon Bérard Lyon, France
2 AZVU, Amsterdam
3 St Radboud Ziekenhuis, Nijmegen, The Netherlands
4Institute of Cancer Research Sutton, U.K.
5 Ospedale San Giovanni, Bellinzona, Switzerland
6Institut Jules Bordet Brussels, Belgium
7 Klinikum der Stadt, Nurnberg, Germany
8Rotterdam Cancer Institute Rotterdam
9 EORTC-N.D.D.O., Amsterdam, The Netherlands
10CRC Dept of Med Oncology Alexander Stone Building, Glasgow, U.K.
Other participants: H. H. Hansen, Rigshospitalet, Copenhagen, Denmark; E. Robinson, Rambam Medical Center, Haifa, Israël; A. Goupil, Centre René Huguenin, Saint-Cloud, France

Correspondence to: Gilles Catimel, M.D. Département de Médecine Centre Léon Bérard 28, rue Laennec F-69373 Lyon,Cédex08 France

BACKGROUND: Gemcitabine is a new pyrimidine antimetabolite with novel metabolic properties and mechanism of action. Phase I clinical trials have demonstrated acceptable toxicity and promising antitumor activity. The objectives of this open multicenter phase II trial were to determine the efficacy and toxicity of this agent in patients with advanced head and neck cancer.

PATIENTS AND METHODS: Sixty-one patients with advanced and/or recurrent squamous cell carcinoma of the head and neck were treated with Gemcitabine as a weekly 30 minutes i.v. administration for 3 consecutive weeks followed by one week rest. The Gemcitabine starting dose was 800 mg/m2/week in 47 patients (a majority being pre-treated with chemotherapy) and was later increased to 1250 mg/m2 in 14 chemotherapy-naive patients. Dose adjustements were based on hematologic and non-hematologic toxicities.

RESULTS: Seven partial responses were observed among 54 evaluable patients, yielding a response rate of 13% (95% confidence interval: 4%–22%). The incidence of hematologic toxicity was low, with grade 3–4 neutropenia in less than 10% of the courses. Fifty-three percent of the patients experienced an increase in liver enzymes, mainly grade 1 or 2. Fatigue was reported by 39% of the patients, frequently associated with flu-like symptoms.

CONCLUSION: Gemcitabine is a drug with documented antitumor activity in patients with advanced squamous cell carcinoma of the head and neck.

head and neck cancer, gemcitabine, phase II study


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