1. Long-term results of weekly paclitaxel carboplatin induction therapy: An effective and well-tolerated treatment in patients with platinum-resistant ovarian cancer
- Author
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Ignace Vergote, C.A.G.M. Van Montfort, M.E.L. van der Burg, H. C. van Doorn, Wendy Onstenk, Karin Leunen, Ingrid A. Boere, Medical Oncology, Hematology, and Obstetrics & Gynecology
- Subjects
Adult ,Oncology ,Cancer Research ,medicine.medical_specialty ,Neutropenia ,Time Factors ,Paclitaxel ,endocrine system diseases ,Vomiting ,medicine.medical_treatment ,Disease-Free Survival ,Drug Administration Schedule ,Carboplatin ,chemistry.chemical_compound ,SDG 3 - Good Health and Well-being ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Humans ,Medicine ,Progression-free survival ,neoplasms ,Aged ,Aged, 80 and over ,Ovarian Neoplasms ,Cisplatin ,Chemotherapy ,business.industry ,Induction chemotherapy ,Nausea ,Induction Chemotherapy ,Middle Aged ,Thrombocytopenia ,female genital diseases and pregnancy complications ,Gemcitabine ,Treatment Outcome ,chemistry ,Drug Resistance, Neoplasm ,Female ,Topotecan ,Neoplasm Grading ,business ,medicine.drug - Abstract
Weekly paclitaxel/cisplatin is effective in platinum-resistant epithelial ovarian cancer (EOC). To reduce toxicity, paclitaxel/cisplatin was replaced by paclitaxel/carboplatin.Patients with progressive EOC after prior 3-weekly paclitaxel/carboplatin were treated with six cycles weekly paclitaxel 90 mg/m(2) and carboplatin area under the curve (AUC) 4 mg/ml/min, followed by six cycles 3-weekly paclitaxel/carboplatin. End-points were progression free survival (PFS), overall survival (OS), response rate (RR) and toxicity.Median progression free interval after last platinum was 9 (0-81) months in 108 patients; 43 were platinum-resistant, of whom 13 started weekly paclitaxel/carboplatin6 months after progression. During 633 weekly cycles grade 3/4 toxicity included; thrombocytopenia 8%, neutropenia 30%, febrile neutropenia 0.5%. Non-haematologic toxicity was low. Treatment was delayed in 16%, and dose reduced in 2% of cycles. RR was 58% for platinum-resistant and 76% for platinum-sensitive patients, median PFS were 8 (range 1-21) and 13 (1-46) months, median OS 15 (1-69) and 26 (4-93) months, respectively. The 13 platinum-resistant patients with a platinum-therapy free interval6 months had a significant shorter PFS (4 versus 10 months, p=0.035) and OS (9 versus 15 months, p=0.002).Six cycles weekly paclitaxel/carboplatin followed by six 3-weekly cycles is well-tolerated and highly active in platinum-resistant and platinum-sensitive patients.
- Published
- 2013