Abstract
Abstract
Background
Weekly paclitaxel/cisplatin is
effective in platinum-resistant epithelial ovarian cancer (EOC). To
reduce toxicity, paclitaxel/cisplatin was replaced by
paclitaxel/carboplatin.
Patients and methods
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.
Results
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/carboplatin <6
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 interval <6
months had a significant shorter PFS (4 versus 10
months,
p=
0.035) and OS (9 versus 15
months,
p=
0.002).
Conclusion
Six
cycles weekly paclitaxel/carboplatin followed by six 3-weekly cycles is
well-tolerated and highly active in platinum-resistant and
platinum-sensitive patients.
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