abstract
OBJECTIVE:
We
compared tolerability, toxicity, response, and
interval debulking
surgery (IDS) outcomes between patients who received
weekly dose-dense
paclitaxel (DDP) and
every three-week platinum to
standard every
three-week taxane plus platinum
neoadjuvant chemotherapy (NACT) for
advanced epithelial
ovarian cancer (EOC).
METHODS:
We
conducted a retrospective study of patients receiving NACT at our
center between June 1, 2012 and July 31, 2015. Patients with stage
III/IV EOC who received at least one cycle of DDP (weekly paclitaxel
plus every three-week carboplatin) or standard taxane (every three-week
paclitaxel or docetaxel plus carboplatin) therapy were included.
Abstracted data included demographics, tolerability, grade 3/4 toxicity,
response, and IDS outcomes. Fisher's exact and student t-test were used
for statistical significance.
RESULTS:
Twenty-one
patients received DDP and 40 received standard taxane. Tolerability was
comparable. More patients receiving DDP experienced grade 3 or 4
toxicity when considered in aggregate (86% vs. 40%; p=0.001). Pathologic
complete response (pCR) was achieved in 14% of DDP patients versus 3%
of standard (p=0.11). 48% of patients in the DDP group were debulked to
no residual disease (NRD) versus 28% in the standard group (p=0.16).
CONCLUSIONS:
While
associated with an increase in
severe toxicity compared to standard
three-week taxane, DDP
(weekly) appears to facilitate higher rates of pCR (
Pathologic
complete response) and NRD (
no residual disease)
for patients receiving NACT in this preliminary study. These results
warrant further investigation of DDP for patients with advanced EOC and
assessment of impact on long-term survival outcomes.
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