Carboplatin Plus Paclitaxel for Advanced or Recurrent Uterine Malignant Mixed Mullerian Tumors : The British Columbia Cancer Agency Experience

Malignant mixed mullerian tumors (MMMTs) of the uterus, also known as carcinosarcomas, are aggressive tumors that rarely are cured by exclusively local treatment. Rather, they require effective chemotherapy. Combination drug regimens based on ifosfamide are inconvenient and comparatively costly. In contrast, carboplatin and paclitaxel (CT) are easily administered and are effective in treating endometrial carcinoma. They would be expected to also be active against MMMT, which now is viewed as being an epithelial tumor. This study surveyed outcomes in 20 women newly diagnosed as having MMMT and 11 others with recurrent disease. Patients first received paclitaxel intravenously in a dose of 175 gm/m 2 over 3 hours, and then carboplatin at monthly intervals for 3 to 6 cycles. Some patients additionally received involved-field irradiation with or without para-aortic node therapy. The 20 newly diagnosed women had a response rate of 60%, with 5 complete and 7 partial responses. Six of the 11 women treated for recurrent disease (55%) responded, 2 of them completely and 4 partially. Median progression-free survival times were 16 months in newly diagnosed women and 12 months in those treated for recurrent disease. Dose reduction proved necessary in 5% of patients. Treatment was delayed in 10% of cases. No patient required filgastrim. A combination of carboplatin and paclitaxel appears to be effective treatment for women with newly diagnosed or recurrent MMMT. Toxicity from this treatment is manageable.