Patients with locally advanced or metastatic cancer of the esophagus have cancer that cannot currently be cured. There is a continuing search for new treatments which may be of benefit to patients with cancer of the esophagus by relieving symptoms (especially difficulty swallowing), prolonging survival and hopefully in the future resulting in cure. A variety of chemotherapy drugs can produce responses in patients with cancer of the esophagus but these responses are usually not complete and are generally of short duration.
The taxanes (paclitaxel and docetaxel) are a relatively new class of chemotherapy drugs which have been shown to produce responses in patients with locally advanced or metastatic cancer of the esophagus. At the American Society of Clinical Oncology meeting in 1999 Doctors in Germany reported outcomes of treatment of 23 patients with cancer of the esophagus with paclitaxel or docetaxel. All patients had metastatic or recurrent cancer and had failed at least one standard chemotherapy regimen usually containing cisplatin and fluorouracil. Patients were randomly assigned to receive either paclitaxel or docetaxel. The complete response rate was 15% and the partial response rate was 15% and 30% had stabilization of cancer with no growth while receiving treatment. The major side effects were low blood counts and two patients died of infection. The response rate was the same for both paclitaxel and docetaxel.
These doctors conclude that paclitaxel and docetaxel were effective drugs for patients who had failed primary treatment with cisplatin and fluorouracil containing regimens. More recently these agents are being evaluated in combination regimens as primary treatment for cancer of the esophagus. (Proceedings of the American society of Clinical Oncology, Vol 18, Abstract 1088, 1999)