Objective. The purpose of this phase 11 trial was to evaluate the efficacy of intravenous paclitaxel in patients with recurrent or advanced leiomyosarcoma of the uterus. Methods. To be eligible, patients with recurrent or persistent leiomyosarcoma of the uterus were to have measurable disease not previously treated with paclitaxel and adequate hematologic (WBC greater than or equal to 3000/mul, platelet count greater than or equal to 100,000/mul), renal (serum creatinine less than or equal to 2.0 mg%), and hepatic (bilirubin less than or equal to 1.5 X institutional normal) functions. Paclitaxel was given at a dose of 175 mg/m(2) (135 m(g)/m(2) for patients with prior radiotherapy) intravenously over 3 It every 3 weeks. Results. Fifty-three patients were entered on this study; 48 were evaluable for toxicity and response. Fifteen had prior irradiation and 39 had prior chemotherapy. A median of 2 (range: 1-12) courses was given. Grade 4 neutropenia occurred in 3 (6.3%) patients. No grade 4 thrombocytopenia was reported and no deaths were attributable to therapy. Four (8.4%) patients had a complete or partial response and 22.9% had stable disease. Conclusions. Although toxicity was minimal, this regimen demonstrated modest activity in patients with previously treated advanced or recurrent leiomyosarcoma of the uterus. (C) 2003 Elsevier Science (USA). All rights reserved.