Background: Optimal management of patients with metastatic cancer of unknown origin (MUO) requires appropriate clinical and pathologic eveluation to identify treatable subgroups and administer specific therapy for each patients subgroup. But, the best treatment in a large population of patients with MUO still remain a problem. Cisplatin-based combination chemotherapy has not been completely studied in Korea. A total of 14 patients with metastatic cancer of unknown origin were studied to evaluate the effectiveness and toxicity of EAP-II combination chemotherapy. Method: All patients were treated with etoposide 20 mg/m continous IV on Dayl-5, Adriamycin 10 mg/m bolus on Day 1, 5 and cisplatin 20 mg/m(2) continous IV on Day 1-5, every 4 weeks. Results: Of 12 patients evaluable for response, 1(8%) had complete response and 6(50%) showed partial response with a objective response rate of 58%. The median duration of response was 9.7(8-20hnonths and the median survival of all patients was 15.5(4-25hnonths, In the analysis of the response according to various characteristics of the patients, there was no significant difference according to various parameters(P>0.05). Toxicity was generally mild. Whereas nausea and vomiting were mild, neuropathy was the dose limiting toxicity. Conclusion: This study indicates that EAP-II regimen is an active therapy against metaatatic cancer of unknown origin but is associated with significent neurotoxicity. Less toxic and more effective treatment protocol is anticipated.
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