1. Oral cyclophosphamide in recurrent ovarian cancer.
- Author
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Handolias D, Quinn M, Foo S, Mileshkin L, Grant P, Dutu G, and Rischin D
- Subjects
- Administration, Oral, Adult, Aged, Antineoplastic Agents, Alkylating adverse effects, Australia, Carcinoma, Ovarian Epithelial, Cyclophosphamide adverse effects, Disease-Free Survival, Female, Humans, Middle Aged, Neoplasm Recurrence, Local pathology, Neoplasms, Glandular and Epithelial mortality, Ovarian Neoplasms mortality, Retrospective Studies, Antineoplastic Agents, Alkylating administration & dosage, Cyclophosphamide administration & dosage, Neoplasms, Glandular and Epithelial drug therapy, Ovarian Neoplasms drug therapy
- Abstract
Aims: Cyclophosphamide was widely used as a single agent prior to the advent of platinum-based regimens for epithelial ovarian cancer, and, in combination with platinum, prior to the adoption of platinum and paclitaxel as standard first-line therapy. As cyclophosphamide currently has no defined role in ovarian cancer we aimed to assess its activity in women with recurrent disease., Methods: A retrospective review was conducted of patients from three centers in Melbourne, Australia who had received oral cyclophosphamide treatment for recurrent ovarian cancer. The primary end-point was response rate to oral cyclophosphamide (150 mg p.o. day 1-14) based on Gynecologic Cancer InterGroup (GCIG) CA125 and/or Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Secondary end-points included overall and progression-free survival and toxicity., Results: In all, 26 patients were identified and 23 patients were evaluable for response. The median number of prior chemotherapy regimens was three (range 1-6). The response rate to oral cyclophosphamide was 44% with 10 of the 23 patients achieving a partial response (PR) based on GCIG (CA125) criteria. The median number of cycles received was three (range 1-16). Cyclophosphamide showed activity both in patients with platinum-sensitive (seven of 13 PR) and resistant or refractory disease (three of 10 PR). There was no grade 3 or 4 toxicity but two patients ceased cyclophosphamide due to less severe non-hematological toxicity., Conclusion: Single agent oral cyclophosphamide is active and well tolerated in recurrent ovarian cancer. Further investigation of oral cyclophosphamide in patients with platinum-sensitive and platinum-resistant disease is warranted., (© 2013 Wiley Publishing Asia Pty Ltd.)
- Published
- 2016
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