Τίτλος:
Sequential combination of paclitaxel-carboplatin and
paclitaxel-liposomal doxorubicin as a first-line treatment in patients
with ovarian cancer - A multicenter phase II trial
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Cisplatin or carboplatin plus paclitaxel is considered the standard
first-line treatment in ovarian cancer. Attempts to maximize tumor
cytoreduction with first-line chemotherapy by incorporating new
promising agents led to sequential drug administration with two or three
doublets. In the present study, we aimed to evaluate the activity and
the tolerance of two sequential doublets (paclitaxel/carboplatin and
liposomal doxorubicin/carboplatin) administered as first-line treatment
in patients with FIGO III/IV ovarian cancer. Treatment consisted of four
cycles of carboplatin ( 6 AUC) plus paclitaxel ( 175 mg/m(2); PC
regimen) followed by four cycles with carboplatin ( 6 AUC) plus
liposomal doxorubicin ( 40 mg/ m(2); LD/C regimen) every 3 weeks.
Forty-one patients in FIGO III or IV were enrolled. In an
intention-to-treat analysis, 20 (49%) complete (CR) and 12 (29%)
partial ( PR) responses were achieved ( overall response rate, ORR:
78%; 95% confidence interval, CI: 64.1 - 91.9%); with the PC regimen
( 164 cycles); 7 (17%) patients have stable (SD) and 2 (5%)
progressive (PD) disease. The LD/C regimen ( 124 cycles) was
administered in 36 (88%) patients because of 2 early deaths and 3
patient withdrawals. Three additional patients, 2 with PR and 1 with SD
after PC chemotherapy) achieved a CR. Upon completion of the LD/C
chemotherapy there were 18 (44%) patients with CR and 9 (22%) with PR
( ORR = 66%; 95% CI: 64 - 92%). The median duration of response was
27 months and the median time to progression 20 months. The probability
of 2-year survival was 67%. Grade 3 and 4 neutropenia was observed in
34 and 14.6% of the patients, respectively, during the PC regimen,
while during the treatment with LD/C the percentages for grade 3 and 4
neutropenia were 44.4 and 19.4%, respectively. Febrile neutropenia
occurred only in patients treated with the PC regimen (4.9%). The
incorporation of liposomal doxorubicin in this sequential doublet
schedule of first-line treatment of ovarian carcinoma created a feasible
and active regimen. Prospective randomized studies are required to
assess its efficacy on patient survival. Copyright (C) 2005 S. Karger
AG, Basel.
Συγγραφείς:
Potamianou, A
Androulakis, N
Papakotoulas, P
Toufexi, H and
Latoufis, C
Kouroussis, C
Christofilakis, C
Xenidis, N and
Georgoulias, V
Polyzos, A
Περιοδικό:
DIAGNOSTIC ONCOLOGY
Λέξεις-κλειδιά:
carboplatin; liposomal doxorubicin; ovarian cancer; paclitaxel
