Abstract 758P
Background
Although several chemotherapies have been reported for advanced extramammary Paget‘s disease (EMPD), there are no proven effective and established regimens. In Japan, docetaxel is widely used, and taxane-based regimens have been suggested to be effective. We have been using paclitaxel (PTX) as first-line chemotherapy for advanced EMPD in our Department, and we report a retrospective review of the efficacy and safety of PTX.
Methods
We conducted a retrospective analysis of the treatment efficacy and adverse events in patients with advanced EMPD treated with PTX in our Department between October 2019 and December 2023. The initial dose of paclitaxel was 80 mg/m2 administered for 3 consecutive weeks on/1–2 weeks off schedule, and the intervals and doses were modified depending on the patient's condition. In the present study, we evaluated the efficacy based on RECIST version 1.1 and adverse events (AEs) based on CTCAE version 4.0. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method.
Results
Twelve patients were enrolled, 10 of whom were male, and their median age was 64 years (range: 40–87 years). The number of metastatic organs before PTX was one in eight patients and two in four patients. The median number of PTX courses was seven (range: 1-20). Staging was stage IIIB in 1 patient and stage IV in 11 patients (referring to Ohara's classification in 2016). Serum lactate dehydrogenase level was elevated in three patients, and carcinoembryonic antigen levels were elevated in seven patients. During the follow-up period, seven patients died because of disease progression. The median PFS was 384 days (95% CI: 126–NA), and the median OS was 507 days (95% CI: 294–NA). The best response during the follow-up period was CR in three, PR in six, SD in two, and PD in one. The response rate was 75% and 1-year OS rate was 75%. Regarding grade 3 or above AEs, grade 3 pancytopenia was observed in only one patient.
Conclusions
EMPD is more common in elderly patients, especially in Asian populations. PTX may be a useful regimen because of its efficacy and safety.
Clinical trial identification
Editorial acknowledgement
We would like to thank Editage (www.editage.jp) for English language editing.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.